East Boston Behavioral Health And Medicine Llc | |
464 Bremen St Ste 4 East Boston MA 02128-1430 | |
(617) 567-9200 | |
(617) 567-9300 |
Full Name | East Boston Behavioral Health And Medicine Llc |
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Speciality | Psychiatry & Neurology |
Location | 464 Bremen St Ste 4, East Boston, Massachusetts |
Authorized Official Name and Position | Sabina Ferreira Tavares (CEO) |
Authorized Official Contact | 6175679200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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East Boston Behavioral Health And Medicine Llc 464 Bremen St Ste 4 East Boston MA 02128-1430 Ph: (617) 359-2146 | East Boston Behavioral Health And Medicine Llc 464 Bremen St Ste 4 East Boston MA 02128-1430 Ph: (617) 567-9200 |
NPI Number | 1669096996 |
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Provider Enumeration Date | 06/02/2020 |
Last Update Date | 10/16/2020 |
Certification Date | 10/16/2020 |
Medicare PECOS PAC ID | 3577977040 |
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Medicare Enrollment ID | O20210123000020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669096996 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Sabina Tavares |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477064293 PECOS PAC ID: 8022377522 Enrollment ID: I20180108002935 |
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