Organization
DANIEL RUTRICK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN MCCLELLAN OFFICE MANAGER (OFFICE MANGER)
(617) 387-2220
Entity
Organization
Contact information
Practice address
617 BROADWAY, EVERETT, MA 02149-3712
(617) 387-2220
(617) 394-0538
Mailing address
617 BROADWAY, EVERETT, MA 02149-3712
(617) 387-2220
(617) 394-0538
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2351
MA
103TC1900X
Counseling Psychologist
8277
MA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
142070
MA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
164216
MA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
36462
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036462
TUFTS GROUP NUMBER
MD
01
—
500019
RUTRICK GROUP PSYCHOLOGIS
MA
01
—
50064
TUFTS CERTIFIED NURSE SPE
MA
01
—
M13835
BLUE SHIELD GROUP NUMBER
MA
Enumeration date
05/22/2007
Last updated
09/11/2025
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