| NPI | 1053101238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY CARL RODRIGUES Authorized Official 781-352-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology |
| 2084E0001X | |
| 2080P0008X Pediatrics Neurodevelopmental Disabilities | |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-10-06 |