| Sports Concussion New England | |
|
1368 Beacon St Suite 116 Brookline MA 02446-2872 | |
| (617) 959-1010 | |
| Not Available |
| Full Name | Sports Concussion New England |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1368 Beacon St, Brookline, Massachusetts |
| Authorized Official Name and Position | Neal F Mcgrath (PRESIDENT) |
| Authorized Official Contact | 6179591010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sports Concussion New England 1368 Beacon St Suite 116 Brookline MA 02446-2872 Ph: (617) 959-1010 | Sports Concussion New England 1368 Beacon St Suite 116 Brookline MA 02446-2872 Ph: (617) 959-1010 |
| NPI Number | 1043453137 |
|---|---|
| Provider Enumeration Date | 04/20/2009 |
| Last Update Date | 04/20/2009 |
| Medicare PECOS PAC ID | 7214214725 |
|---|---|
| Medicare Enrollment ID | O20170511000646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043453137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 3972 (Massachusetts) | Primary |
| Provider Name | Neal F Mcgrath |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184780561 PECOS PAC ID: 9032496542 Enrollment ID: I20170511000787 |
| Provider Name | Alexandra Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285983759 PECOS PAC ID: 9436425535 Enrollment ID: I20171017002539 |
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