Mystic Valley Urological Associates, INC

NPI #1114452547 in Stoneham, Massachusetts

Provider Information

NPI Number: 1114452547
Entity Type: Organization
Organization Name: Mystic Valley Urological Associates, INC
Subpart: Yes (part of a larger organization)
Parent Organization: MYSTIC VALLEY UROLOGICAL ASSOCIATES, INC
Primary Specialty: Urology
Enumeration Date: Apr 24, 2017
Last Updated: Apr 24, 2017

Practice Location

Address: 3 WOODLAND RD
Address 2: SUITE 216
City: Stoneham
State: Massachusetts
ZIP Code: 02180-1702
Phone: (781) 979-0661

Authorized Official

Name: MARJIE C HALUSKA
Title: DIRECTOR OF BUSINESS OPERATIONS
Phone: (781) 462-3040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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