Provider Demographics
NPI:1730206491
Name:NEWTON-WELLESLEY NEUROLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:NEWTON-WELLESLEY NEUROLOGY ASSOCIATES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMOZLINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-928-1500
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:GREEN 567
Mailing Address - City:NEWTON LOWER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-928-1500
Mailing Address - Fax:617-630-0860
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:GREEN 567
Practice Address - City:NEWTON LOWER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-928-1500
Practice Address - Fax:617-630-0860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9718940Medicaid
MAAA38422OtherHPHC-GRP PROVIDER ID
MAM18352OtherBCBS MA-GRP PROVIDER ID
MAM21365Medicare ID - Type UnspecifiedGROUP PROVIDER ID