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1740082007
SUDEEP GC
BROCKTON, MA
NPI
1740082007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MA 2278501)
Enumeration Date
2025-03-26
Last Update Date
2025-03-26
Business Address
SUDEEP GC
940 BELMONT ST BLDG 2
BROCKTON, MA 02301-5596
Phone number: 774-826-2079
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Mailing Address
SUDEEP GC
133 TAYLOR ST
MALDEN, MA 02148-8021
Phone number: 205-413-0878
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