Basic Information
Provider Information
NPI: 1366737868
EntityType: 2
ReplacementNPI:  
OrganizationName: ATRIUS HEALTH, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: HARVARD VANGUARD MEDICAL ASSOCIATES
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 275 GROVE ST
Address2: SUITE 3-300
City: AUBURNDALE
State: MA
PostalCode: 024662272
CountryCode: US
TelephoneNumber: 6175598374
FaxNumber: 6174213487
Practice Location
Address1: 420 LIBBEY INDUSTRIAL PKWY
Address2: WEYMOUTH MRI
City: WEYMOUTH
State: MA
PostalCode: 021893134
CountryCode: US
TelephoneNumber: 7813319880
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/13/2011
LastUpdateDate: 06/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STRONGWATER
AuthorizedOfficialFirstName: STEVE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 6175598042
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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