Organization
ICCD PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL CASTRO PH.D. (EXECUTIVE DIRECTOR)
(781) 619-1500
Entity
Organization
Contact information
Practice address
340 TURNPIKE ST, CANTON, MA 02021-2700
(781) 619-1500
(617) 527-0640
Mailing address
340 TURNPIKE ST, CANTON, MA 02021-2700
(781) 619-1500
(617) 527-0640
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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