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Organization

REDIGER PSYCHIATRIC SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY D. REDIGER M.D. (PSYCHIATRIST)
(774) 419-1017
Entity
Organization

Contact information

Practice address
235 N PEARL ST, BROCKTON, MA 02301-1794
(508) 588-4000
Mailing address
235 N PEARL ST, BROCKTON, MA 02301-1794
(508) 588-4000
(508) 894-8334

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
159462
MA
364SA2200X
Adult Health Clinical Nurse Specialist
170600
MA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
133760
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1326286873
BLUE CROSS
MA
01
DR9410
RAILROAD MEDICARE
MA
Enumeration date
01/21/2009
Last updated
04/18/2014
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