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179 Longwood Ave Boston MA 02115-5804 | |
(973) 978-1004 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 179 Longwood Ave, Boston, Massachusetts |
Authorized Official Name and Position | Michael G Carvalho (PROFESSOR AND CHAIR, PHARMACY PRACT) |
Authorized Official Contact | 6177351053 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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179 Longwood Ave Boston MA 02115-5804 Ph: (973) 978-1004 | 179 Longwood Ave Boston MA 02115-5804 Ph: (973) 978-1004 |
NPI Number | 1750799110 |
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Provider Enumeration Date | 07/30/2014 |
Last Update Date | 07/30/2014 |
Identifier | Type | State | Issuer |
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1750799110 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | PH234175 (Massachusetts) | Primary |
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