| NPI | 1831329523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK C POLONSKY President 617-566-7508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: MA 37465) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2009-07-16 |