Newton Wellesley Primary Care P C | |
40 Walnut St Wellesley MA 02481-2173 | |
(781) 943-3000 | |
(781) 943-3001 |
Full Name | Newton Wellesley Primary Care P C |
---|---|
Speciality | Internal Medicine |
Location | 40 Walnut St, Wellesley, Massachusetts |
Authorized Official Name and Position | William B Holgerson (PRESIDENT) |
Authorized Official Contact | 7812351224 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Newton Wellesley Primary Care P C 40 Walnut St Wellesley MA 02481-2173 Ph: (781) 943-3000 | Newton Wellesley Primary Care P C 40 Walnut St Wellesley MA 02481-2173 Ph: (781) 943-3000 |
NPI Number | 1003911579 |
---|---|
Provider Enumeration Date | 09/13/2006 |
Last Update Date | 03/09/2017 |
Medicare PECOS PAC ID | 2961471255 |
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Medicare Enrollment ID | O20041004000115 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003911579 | NPI | - | NPPES |
9777644 | Other | MA | MASSHEALTH GROUP# |
607309 | Other | MA | TUFTS GROUP # |
M16342 | Other | MA | BLUESHIELD NEWTON GRP# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Massachusetts) | Primary |
Provider Name | Jeanne L Richard |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306940838 PECOS PAC ID: 1759356785 Enrollment ID: I20040901000669 |
Provider Name | Kathryn M Deanzeris |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922056035 PECOS PAC ID: 8729015037 Enrollment ID: I20050719000463 |
Provider Name | Edward J Legare |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528084191 PECOS PAC ID: 2567478845 Enrollment ID: I20070914000046 |
Provider Name | Eric A Serrano |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295803146 PECOS PAC ID: 0446345706 Enrollment ID: I20071001000782 |
Provider Name | William B Holgerson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1356445829 PECOS PAC ID: 8224007513 Enrollment ID: I20071012000324 |
Provider Name | William C Liaw |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1912954611 PECOS PAC ID: 7012101215 Enrollment ID: I20101102000255 |
Provider Name | Charles C Pao |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063516573 PECOS PAC ID: 5991999195 Enrollment ID: I20101102000307 |
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