Organization
MELROSE-WAKEFIELD BEHAVORIAL HEALTH CENTER, P.C.
Active
Parent organization
MELROSE-WAKEFIELD BEHAVORIAL HEALTH CENTER, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MELROSE-WAKEFIELD BEHAVORIAL HEALTH CENTER, P.C.
Authorized official
DR. LALITH M. TISSERA (MEDICAL DIRECTOR)
(781) 224-0661
Entity
Organization
Contact information
Practice address
800 W CUMMINGS PARK, SUITE 4700, WOBURN, MA 01801-6372
(781) 224-0661
(781) 224-1993
Mailing address
800 W CUMMINGS PARK, SUITE 4700, WOBURN, MA 01801-6372
(781) 224-0661
(781) 224-1993
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
81635
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007792
VALUE OPTIONS
MA
01
—
007792
VALUE OPTIONS
MD
01
—
222936
PACIFICARE
MA
01
—
3143741
MEDICAID
MA
05
—
3143741
—
MA
01
—
776747
TUFTS
MA
01
—
A20487
MEDICARE
MA
01
—
G10083
MEDICARE UPIN
MA
01
—
J16485
BLUECROSSBLUE SHIELD
MA
01
—
M19048
BLUE CROSS BLUE SHIELD
MA
01
—
M21864
MEDICARE PIN
MA
Enumeration date
07/31/2006
Last updated
02/29/2016
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