Provider Demographics
NPI:1588308035
Name:BAYSTATE NEW ENGLAND ORTHOPEDIC SURGEONS ALLIANCE, LLC
Entity type:Organization
Organization Name:BAYSTATE NEW ENGLAND ORTHOPEDIC SURGEONS ALLIANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:DANAHY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:727-235-1481
Mailing Address - Street 1:50 WASON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1280
Mailing Address - Country:US
Mailing Address - Phone:413-286-1020
Mailing Address - Fax:413-286-1019
Practice Address - Street 1:50 WASON AVE FL 2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1280
Practice Address - Country:US
Practice Address - Phone:413-286-1020
Practice Address - Fax:413-286-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical