Provider Demographics
NPI:1811063688
Name:MEDICAL ASSOCIATES OF NEW ENGLAND
Entity type:Organization
Organization Name:MEDICAL ASSOCIATES OF NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDULFATAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-769-7070
Mailing Address - Street 1:95 CHAPEL ST
Mailing Address - Street 2:SUITE 2-D
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3155
Mailing Address - Country:US
Mailing Address - Phone:781-769-7070
Mailing Address - Fax:781-769-7085
Practice Address - Street 1:95 CHAPEL ST
Practice Address - Street 2:SUITE 2-D
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3155
Practice Address - Country:US
Practice Address - Phone:781-769-7070
Practice Address - Fax:781-769-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-25
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18475OtherBCBS
MA0034046OtherNIEGHBORHOOD HEALTH
MADD6692OtherRAILROAD MEDICARE
MA9714821Medicaid
MA000000027373OtherBMC HEALTHNET
MA603103OtherTUFTS HEALTH PLAN
MA696660OtherHARVARD PILGRIM HEALTH
MA0034046OtherNIEGHBORHOOD HEALTH