| NPI | 1518975184 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PUNYAMURTULA S KISHORE President 617-738-4640  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine | 
| Additional Taxonomies | 207Q00000X Family Medicine | 
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2006-08-03 | 
| Last Update Date | 2025-09-11 |