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Organization

PYRAMID BUILDER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MATEUS BARBOSA (CLINICIAN)
(617) 650-8146
Entity
Organization

Contact information

Practice address
35 FOX ST, DORCHESTER, MA 02122-1722
(617) 650-8146
Mailing address
35 FOX ST, DORCHESTER, MA 02122-1722

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
302R00000X
MA

Other

Enumeration date
02/22/2009
Last updated
02/22/2009
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