Provider Demographics
NPI:1548310949
Name:NORTH SUBURBAN INTERNAL MEDICINE & GASTROENTEROLOGICAL ASSOCIATES
Entity type:Organization
Organization Name:NORTH SUBURBAN INTERNAL MEDICINE & GASTROENTEROLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHINTAMANI
Authorized Official - Middle Name:BHASKAR
Authorized Official - Last Name:GOKHALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-388-9228
Mailing Address - Street 1:214 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-6907
Mailing Address - Country:US
Mailing Address - Phone:781-388-9228
Mailing Address - Fax:781-388-7787
Practice Address - Street 1:214 MAIN ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-6907
Practice Address - Country:US
Practice Address - Phone:781-388-9228
Practice Address - Fax:781-388-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty