NPI | 1740945534 |
---|---|
Entity Type | Organization |
Authorized Contact | GIANNA PAPA Credentialing Manager 617-894-1718 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261Q00000X |
Enumeration Date | 2021-11-05 |
Last Update Date | 2023-01-27 |