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Organization
PREVENTIVE MEDICINE ASSOCIATES
Active
Organization
PREVENTIVE MEDICINE ASSOCIATES
Active
Other names
Neuroscience Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY J DELONG MM, RHIA (CREDENTIALING MANAGER)
(413) 222-7711
Entity
Organization
Contact information
Practice address
1842 BEACON ST, BROOKLINE, MA 02445-1930
(617) 278-1478
(617) 278-1471
Mailing address
1842 BEACON ST, BROOKLINE, MA 02445-1930
(617) 278-1478
(617) 278-1471
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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