Organization
ST. VINCENT PSYCHIATRY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGE BOTSARIS MD (MANAGER)
(508) 869-2699
Entity
Organization
Contact information
Practice address
123 SUMMER ST, DEPARTMENT OF PSYCHIATRY, WORCESTER, MA 01608-1216
(508) 869-2699
Mailing address
PO BOX 1085, BOYLSTON, MA 01505-1685
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9733060
—
MA
Enumeration date
10/28/2006
Last updated
08/22/2020
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