| NPI | 1366797771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN R BLUMBERG Manager 617-775-7804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MA 206504) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2012-07-23 |