Provider Demographics
NPI:1871562694
Name:HARRINGTON MEMORIAL RADIOLOGY, PC
Entity type:Organization
Organization Name:HARRINGTON MEMORIAL RADIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF RADIOLOGIST, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAZZINI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-765-9771
Mailing Address - Street 1:15 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-2928
Mailing Address - Country:US
Mailing Address - Phone:508-984-1410
Mailing Address - Fax:508-979-8981
Practice Address - Street 1:100 SOUTH ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-4051
Practice Address - Country:US
Practice Address - Phone:508-765-9771
Practice Address - Fax:508-764-9410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA680472OtherTUFTS HEALTH PLAN
MA9785086Medicaid
MA38408OtherFALLON COMMUNITY HLTH PLA
MAM17187OtherBLUE SHIELD
MA9785086Medicaid