Organization
UNIVERSITY NEUROPSYCHOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILES TARTER PSY.D. (PRESIDENT)
(617) 877-5978
Entity
Organization
Contact information
Practice address
364 HARVARD ST, SUITE 1, BROOKLINE, MA 02446-2920
(617) 877-5978
(206) 666-3687
Mailing address
491 DUTTON ST, #304, LOWELL, MA 01854-4289
(617) 877-5978
(206) 666-3687
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
8703
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659498103
INDIVIDUAL NPI
—
Enumeration date
05/01/2009
Last updated
08/25/2015
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