| NPI | 1942250956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE WALLACE Cheif Executive Officer 617-559-8096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207K00000X Allergy & Immunology | |
| 207X00000X Orthopaedic Surgery | |
| 207W00000X Ophthalmology | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 2085R0203X Radiology, Therapeutic Radiology | |
| 208600000X Surgery | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 103T00000X Psychologist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-10-31 |