| NPI | 1164407763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIANNA PAPA Credentialing Manager 617-894-1718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: FL ME81042) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-10-16 |