| NPI | 1396091070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIANNA PAPA Credentialing Manager 617-894-1718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME81042) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2023-01-26 |