Individual
MANUEL N PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 WASHINGTON ST, TUFTS MEDICAL CENTER BOX 1007, BOSTON, MA 02111-1552
(617) 872-6522
(617) 876-9998
Mailing address
PO BOX 440304, WEST SOMERVILLE, MA 02144-0027
(617) 872-6522
(617) 876-9998
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
216680
MA
2084P0015X
Psychosomatic Medicine Physician
Primary
216680
MA
2084P0800X
Psychiatry Physician
216680
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106655
—
MA
Enumeration date
11/04/2005
Last updated
03/29/2011
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