Provider Demographics
NPI:1902298136
Name:CENTURY MEDICAL, PC
Entity type:Organization
Organization Name:CENTURY MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-594-8980
Mailing Address - Street 1:84 HIGHLAND AVE
Mailing Address - Street 2:SUITE # 312
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2727
Mailing Address - Country:US
Mailing Address - Phone:978-594-8980
Mailing Address - Fax:978-594-8951
Practice Address - Street 1:84 HIGHLAND AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2727
Practice Address - Country:US
Practice Address - Phone:978-594-8980
Practice Address - Fax:978-594-8951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226433207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty