Organization
CODMAN SQUARE HEALTH CENTER
Active
Parent organization
CODMAN SQUARE HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
CODMAN SQUARE HEALTH CENTER
Authorized official
PHILIP SEVERIN MD (MEDICAL DIRECTOR)
(617) 825-9660
Entity
Organization
Contact information
Practice address
637 WASHINGTON STREET, DORCHESTER, MA 02124
(617) 825-9660
(617) 288-7898
Mailing address
637 WASHINGTON STREET, DORCHESTER, MA 02124
(617) 825-9660
(617) 288-7898
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2748
MA
Other
Enumeration date
02/22/2008
Last updated
02/22/2008
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