| Specialty Ic Mass Llc | |
|
30 Braintree Hill Office Park Ste 103 Braintree MA 02184-8751 | |
| (212) 776-9090 | |
| (800) 540-1852 |
| Full Name | Specialty Ic Mass Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 30 Braintree Hill Office Park Ste 103, Braintree, Massachusetts |
| Authorized Official Name and Position | Sue Rottura (DIRECTOR) |
| Authorized Official Contact | 5613238987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Ic Mass Llc 1047 Surf Ave Ste 2 Brooklyn NY 11224-2810 Ph: (212) 776-9090 | Specialty Ic Mass Llc 30 Braintree Hill Office Park Ste 103 Braintree MA 02184-8751 Ph: (212) 776-9090 |
| NPI Number | 1346713708 |
|---|---|
| Provider Enumeration Date | 01/09/2019 |
| Last Update Date | 02/05/2024 |
| Medicare PECOS PAC ID | 2062877046 |
|---|---|
| Medicare Enrollment ID | O20230426001234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346713708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QB0002X | Family Medicine - Obesity Medicine | (* (Not Available)) | Secondary |
| 261QI0500X | Clinic/center - Infusion Therapy | (* (Not Available)) | Primary |
| Provider Name | Theresa A Piotrowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598794505 PECOS PAC ID: 0547227951 Enrollment ID: I20091123000178 |
| Provider Name | Linesary Cezaire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467950741 PECOS PAC ID: 3971842840 Enrollment ID: I20190312001029 |
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