Organization · Type 2 NPI

Mass General Waltham

Health Service Clinic/Center · Waltham, MA

NPI number 1710070313 Active

Practice location

52 Second Ave Fl 4
Waltham, MA 02451-1127

Call (781) 487-4390 Map

Fax (781) 487-4391

Mailing address

55 Fruit St, GRB05-ATTENTION Karen Ryle
Boston, MA 02114-2621

Specialties and licenses

Taxonomy	Code	License
Health Service Clinic/Center Primary	261QH0100X	MA0049076 (MA)

Health Service Clinic/Center: Definition to come...

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NPI record

NPI: 1710070313
Entity type: Organization (Type 2)
Issued: Oct 2, 2006
Last updated: Aug 31, 2022
Status: Active
Subpart: Yes of The General Hospital Corporation

Other names

<unavail>
General Hospital Corp · doing business as
General Hospital Corp · doing business as

Authorized official

Sally Mason Boemer
EVP of Administration & Finance
(617) 724-4537

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1710070313

Mass General Waltham's National Provider Identifier is 1710070313, issued on Oct 2, 2006. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Waltham, MA. The record was last updated on Aug 31, 2022.