Organization
TOWARD INDEPENDENT LIVING AND LEARNING
Active
Other names
TILL Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DAFNA KROUK-GORDON (PRESIDENT)
(781) 302-4600
Entity
Organization
Contact information
Practice address
20 EASTBROOK RD, SUITE 201, DEDHAM, MA 02026-2075
(781) 302-4600
Mailing address
20 EASTBROOK RD, SUITE 201, DEDHAM, MA 02026-2075
(781) 302-4600
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
73077
MA
363LA2200X
Adult Health Nurse Practitioner
199217
MA
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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