| Childrens Brain Institute Llc | |
|
76 Bedford St Ste 14 Lexington MA 02420-4640 | |
| (818) 630-0077 | |
| (781) 863-0005 |
| Full Name | Childrens Brain Institute Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 76 Bedford St Ste 14, Lexington, Massachusetts |
| Authorized Official Name and Position | Yaman Eksioglu (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6179094142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Brain Institute Llc 3204 Main Campus Dr Lexington MA 02421-8627 Ph: (617) 899-5109 | Childrens Brain Institute Llc 76 Bedford St Ste 14 Lexington MA 02420-4640 Ph: (818) 630-0077 |
| NPI Number | 1922692474 |
|---|---|
| Provider Enumeration Date | 02/25/2021 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Medicare PECOS PAC ID | 6002224649 |
|---|---|
| Medicare Enrollment ID | O20210420000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922692474 | NPI | - | NPPES |
| 1326071911 | Other | MA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Primary |
| Provider Name | Yaman Z Eksioglu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326071911 PECOS PAC ID: 4082650338 Enrollment ID: I20050708000053 |
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