| NPI | 1316184005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON FAYNZILBERG President 617-817-2070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MA 160820) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: MA 160820) |
| 261QP3300X Clinic/Center, Pain (Licence: MA 160820) | |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-01-16 |