Organization
LONGEVITY GROUP LLC
Active
Organization
LONGEVITY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANITA BODROGNE SZABO MD (OWNER)
(508) 484-3251
Entity
Organization
Contact information
Practice address
76 N BEDFORD ST UNIT A-4, EAST BRIDGEWATER, MA 02333-1182
(598) 484-3251
Mailing address
57 MIRANDA WAY, BRIDGEWATER, MA 02324-1481
(508) 697-6385
(978) 630-6052
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
MA
167G00000X
Licensed Psychiatric Technician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
233962
MA
2084P0015X
Psychosomatic Medicine Physician
233962
MA
2084P0800X
Psychiatry Physician
Primary
233962
MA
2084P0805X
Geriatric Psychiatry Physician
233962
MA
Other
Enumeration date
01/04/2018
Last updated
06/16/2018
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