Organization
HAVEN MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJAY BASU MD (CEO)
(617) 646-9912
Entity
Organization
Contact information
Practice address
86 BAKER AVENUE EXT, CONCORD, MA 01742-2132
(978) 391-9275
Mailing address
86 BAKER AVENUE EXT, CONCORD, MA 01742-2132
(978) 391-9275
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
06/19/2015
Last updated
01/10/2018
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