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Contact Information

DEDHAM MEDICAL ASSOCIATE
1 LYONS STREET
DEDHAM, MA02026
 Phone: 781-329-1400
 Fax: 781-278-5667
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for DEDHAM MEDICAL ASSOCIATE

NPI Number 1063430643
LBN Legal business name DEDHAM MEDICAL ASSOCIATE
Authorized official RICHARD RUSSO - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/18/2006
Last updated 07/21/2022 - About 4 years ago
Identifiers
MA Medicaid 9766529
MA Medicaid 9766537
MA Medicaid 9766545
MA Medicaid 9766553
MA Medicaid 9766561
MA Medicaid 9766588
MA Medicaid 9766596
MA Medicaid 9766618
MA Medicaid 9766626
MA Medicaid 9766634
MA Medicaid M11531
MA Medicaid M12735
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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