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Organization
CENTRE PEDIATRIC ASSOCIATES PC
Active
Organization
CENTRE PEDIATRIC ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE WILLARD BUNNELL M.D. (PRESIDENT)
(617) 735-8585
Entity
Organization
Contact information
Practice address
1 BROOKLINE PL, SUITE 327, BROOKLINE, MA 02445-7224
(617) 735-8585
(617) 232-0572
Mailing address
1 BROOKLINE PL, SUITE 327, BROOKLINE, MA 02445-7224
(617) 735-8585
(617) 232-0572
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
NA
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
711716
TUFTS
MA
01
—
92057
AETNA USHEALTHCARE
MA
05
—
9767312
—
MA
01
—
M14606
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/16/2006
Last updated
08/22/2020
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