| Ambama Clinic Pc | |
|
56 Cottage Grove Ave Brockton MA 02301-6347 | |
| (617) 296-0720 | |
| (617) 296-5166 |
| Full Name | Ambama Clinic Pc |
|---|---|
| Speciality | Internal Medicine - Adolescent Medicine |
| Location | 56 Cottage Grove Ave, Brockton, Massachusetts |
| Authorized Official Name and Position | Ashok J Patel (MANAGER) |
| Authorized Official Contact | 6172960720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ambama Clinic Pc 56 Cottage Grove Ave Brockton MA 02301-6347 Ph: (617) 296-0720 | Ambama Clinic Pc 56 Cottage Grove Ave Brockton MA 02301-6347 Ph: (617) 296-0720 |
| NPI Number | 1205992989 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 01/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205992989 | NPI | - | NPPES |
| 9728350 | Medicaid | MA | |
| 0030542 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| M18330 | Other | MA | BLUE CROSS BLUE SHIELD MA |
| DA4008 | Other | MA | RAILROAD MEDICARE GROUP |
| 697380 | Other | MA | TUFTS HEALTH PLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | 52194 (Massachusetts) | Primary |
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