Individual
EDWARD TABASKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-2458
Mailing address
940 BELMONT ST, BROCKTON, MA 02301-5596
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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