Provider Demographics
NPI:1043032931
Name:NEW ENGLAND REGENERATIVE SERVICES LLC
Entity type:Organization
Organization Name:NEW ENGLAND REGENERATIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-632-2657
Mailing Address - Street 1:PO BOX 716
Mailing Address - Street 2:
Mailing Address - City:WEST OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03890-0716
Mailing Address - Country:US
Mailing Address - Phone:207-632-2657
Mailing Address - Fax:
Practice Address - Street 1:405 HUCKINS RD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:NH
Practice Address - Zip Code:03836-4418
Practice Address - Country:US
Practice Address - Phone:207-632-2657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health