Provider Demographics
NPI:1194349936
Name:METROWEST ULTRASOUND LLC
Entity type:Organization
Organization Name:METROWEST ULTRASOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:YOUSSEF
Authorized Official - Middle Name:H
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:MB,CHB, RDMS
Authorized Official - Phone:508-333-7333
Mailing Address - Street 1:102 HERITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-3007
Mailing Address - Country:US
Mailing Address - Phone:508-333-7333
Mailing Address - Fax:
Practice Address - Street 1:67 UNION ST
Practice Address - Street 2:MEDICAL OFFICE BUILDING SUITE 306
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:508-333-7333
Practice Address - Fax:508-463-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1972125102OtherMEDICARE