Organization
PRATT MEDICAL GROUP, INC
Active
Parent organization
PRATT MEDICAL GROUP, INC
Other names
Wellesley Center for Sleep Medicine, Tufts Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRATT MEDICAL GROUP, INC
Authorized official
THEODORE BUKOWSKI (CFO)
(617) 636-5410
Entity
Organization
Contact information
Practice address
873 WORCESTER ST, WELLESLEY, MA 02482-3714
(617) 636-5000
Mailing address
PO BOX 11218, BOSTON, MA 02211-1218
(617) 636-2546
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SF063069
BCBS MA
MA
Enumeration date
11/29/2007
Last updated
07/17/2009
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