Unknown Individual – Anesthesiology Physician, NPI 1174594782

Unknown Individual is a healthcare provider. based in Medford, Massachusetts. specializing in Anesthesiology Physician. They hold a License No. 30665 (MA). The NPI Number for Unknown Individual is 1174594782

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174594782
Phone
(781) 396-1002
Address
170 GOVERNORS AVE
Deactivation Date
5 June 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Lawrence Memorial Hospital, 170, Governors Avenue, Medford, Middlesex County, Massachusetts, 02155, United States

    MEDFORD, MA 021551643

    Phone: (781) 396-1002

    Fax: (781) 393-8718

    Type: Location

  • 582, Beacon Street, Newton Centre, Newton, Middlesex County, Massachusetts, 02459, United States

    NEWTON, MA 024592024

    Phone: (781) 396-1002

    Fax: (781) 393-8718

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02155)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1174594782.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Anesthesiology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Medford, Massachusetts in registry-derived data.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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