| Collegial Psychiatry And Behavioral Medicine,inc | |
|
1077 W Boylston St Worcester MA 01606-1144 | |
| (774) 479-6361 | |
| Not Available |
| Full Name | Collegial Psychiatry And Behavioral Medicine,inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1077 W Boylston St, Worcester, Massachusetts |
| Authorized Official Name and Position | Pauline Eteng (DNP, PMHNP-BC/PRESIDENT) |
| Authorized Official Contact | 7744796361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collegial Psychiatry And Behavioral Medicine,inc 1077 W Boylston St Worcester MA 01606-1144 Ph: () - | Collegial Psychiatry And Behavioral Medicine,inc 1077 W Boylston St Worcester MA 01606-1144 Ph: (774) 479-6361 |
| NPI Number | 1225773518 |
|---|---|
| Provider Enumeration Date | 05/01/2022 |
| Last Update Date | 08/09/2024 |
| Certification Date | 08/08/2024 |
| Medicare PECOS PAC ID | 2567827744 |
|---|---|
| Medicare Enrollment ID | O20230421001003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225773518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Pauline Temu Eteng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487026399 PECOS PAC ID: 3779880570 Enrollment ID: I20160322001724 |
| Provider Name | Margaret Oluwabamike Akintan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639829880 PECOS PAC ID: 1456738103 Enrollment ID: I20220518000970 |
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