Middlesex Recovery Professional Corporation

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

72453 Issued in MA

Legal business name

MIDDLESEX RECOVERY PROFESSIONAL CORPORATION

Practice address

405 Pearl St
Suite 4
Malden, MA 02148-6644

Phone

(781) 605-0944

Fax

(781) 605-3710

NPI assigned

Jan 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brian William O'Connor, M.D.

Title

President

Phone

(781) 605-0944

Specialties & licenses 1

Addresses

Tax ID family

Middlesex Recovery PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Middlesex Recovery, P.C.

  • Addiction Medicine (Family Medicine) Physician
  • Woburn, MA
  • NPI 1659727592
  NPD tax ID
• Middlesex Recovery, P.C.

  • Addiction Medicine (Preventive Medicine) Physician
  • Salem, NH
  • NPI 1033712179
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1962774638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 PEARL ST",
            "address_2": "SUITE 4",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486644",
            "telephone_number": "781-605-0944",
            "fax_number": "781-605-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 PEARL ST",
            "address_2": "SUITE 4",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486644",
            "telephone_number": "781-605-0944",
            "fax_number": "781-605-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX RECOVERY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-605-0944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MA",
            "license": "72453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Mendelson
• Kerlie Merizier
• Merrimack Valley Hospice, Inc.
• Kelida Michel
• Jacqueline Michetti, RD, LDN
• Millennial Healthcare Solutions
• George Milowe, M.D.
• Erica R Mintzer, MD
• Silvia Minucci
• Devaki Jaydeep Mirashi

• Addiction Medicine (Family Medicine) Physician in Malden, MA
• Providers in Malden, MA by specialty
• Addiction Medicine (Family Medicine) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.