Organization
NEWGENN PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERTA KOOSONO ADU NP (CNP)
(774) 364-8183
Entity
Organization
Contact information
Practice address
303 WYMAN ST STE 300, WALTHAM, MA 02451-1255
(774) 364-8183
Mailing address
303 WYMAN ST STE 300, WALTHAM, MA 02451-1255
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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