Organization
PSYCHMATRIX FOR CHILD & ADOLESCENT PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CARY MD (OWNER)
(413) 596-4601
Entity
Organization
Contact information
Practice address
35 POST OFFICE PARK STE 3505, WILBRAHAM, MA 01095-1186
(413) 596-4601
(413) 596-4609
Mailing address
12 RUTH DR, WILBRAHAM, MA 01095-2610
(413) 596-4601
(413) 596-4609
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
73294
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3078540
—
MA
01
—
586023
TUFTS
MA
01
—
M18872
BCBS
MA
Enumeration date
07/12/2007
Last updated
07/12/2007
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