| NPI | 1740798008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINE W NDIFOR Administrator 617-413-4952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| 261Q00000X Clinic/Center | |
| 261QP2300X Clinic/Center, Primary Care (Licence: MN 3233) | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-19 |