Organization
CHILDRENS BRAIN INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAMAN EKSIOGLU MD (AUTHORIZED OFFICIAL)
(617) 909-4142
Entity
Organization
Contact information
Practice address
76 BEDFORD ST STE 14, LEXINGTON, MA 02420-4640
(818) 630-0077
(781) 863-0005
Mailing address
3204 MAIN CAMPUS DR, LEXINGTON, MA 02421-8627
(617) 899-5109
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326071911
INDIVIDUAL NPI
MA
Enumeration date
02/25/2021
Last updated
02/07/2024
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