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Organization

SQUARE MEDICAL GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NATALIE LEONID LENDER M.D. (MEDICAL DIRECTOR, OWNER)
(617) 916-5069
Entity
Organization

Contact information

Practice address
124 WATERTOWN ST, SUITE 2D, WATERTOWN, MA 02472-2576
(617) 916-5069
(617) 467-4073
Mailing address
124 WATERTOWN ST, SUITE 2D, WATERTOWN, MA 02472-2576
(617) 916-5069
(617) 467-4073

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
152859
MA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
152859
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3173615
MA
Enumeration date
04/18/2008
Last updated
08/13/2015
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