| NPI | 1730485897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN S CHARLAP Chief Service Officer 617-319-6434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 103T00000X Psychologist |
| 133V00000X Dietitian, Registered | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: FL ME89947) | |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2011-11-28 |