| NPI | 1033464276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RENNA CFO 617-419-4772 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI 00117) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: RI 00117) |
| 103TP0016X Psychologist Prescribing (Medical) (Licence: RI 00117) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: RI 00117) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: RI 00117) | |
| 363L00000X Nurse Practitioner (Licence: RI 00117) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2012-07-30 |