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Organization

EDINBURG CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARINA KAGAN (BILLING MANAGER)
(781) 761-5208
Entity
Organization

Contact information

Practice address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
(781) 761-5208
(781) 275-7205
Mailing address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
(781) 761-5064
(781) 275-7205

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1303237
MBHP
MA
01
1303287
MBHP
MA
05
1303287
MA
01
1304267
MBHP
MA
05
1304267
MA
01
M18633
BCBS
MA
Enumeration date
09/08/2006
Last updated
06/29/2022
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