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1842 Beacon St Brookline MA 02445-1930 | |
| (617) 278-1478 | |
| (617) 278-1471 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 1842 Beacon St, Brookline, Massachusetts |
| Authorized Official Name and Position | Mary J Delong (CREDENTIALING MANAGER) |
| Authorized Official Contact | 4132227711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1842 Beacon St Brookline MA 02445-1930 Ph: (617) 278-1478 | 1842 Beacon St Brookline MA 02445-1930 Ph: (617) 278-1478 |
| NPI Number | 1376782466 |
|---|---|
| Provider Enumeration Date | 02/12/2009 |
| Last Update Date | 02/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376782466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
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