| NPI | 1720879844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH GORDON Administrator 617-921-1458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-05-16 |