Racinmd Llc

NPI 1154725141 - Psychiatry & Neurology - 2084P0804X

NPI Details
NPI 1154725141
Enumeration Date 10/20/2014
Last Updated 10/20/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name REVITAL REVITAL
Position PSYCHIATRIST
Phone (617) 993-6100
Fax (617) 993-6106
Practice Location
1180 BEACON ST
SUITE 7D
BROOKLINE MA, 02446-3885, US
Phone (617) 993-6100
Fax (617) 993-6106
Business Location
1180 BEACON ST
SUITE 7D
BROOKLINE MA, 02446-3885, US
Phone (617) 993-6100
Fax (617) 993-6106
Toxanomy
Taxonomy Code 2084P0804X
License State Massachusetts
License Number 258205
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According to our database, Racinmd Llc NPI is 1154725141, taxonomy code is 2084P0804X and license number is 258205, license state is located at Massachusetts. Racinmd Llc physically located at 1180 Beacon St, Brookline MA, 02446-3885. NPI Number 1033115704 has the healthcare provider type.

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1154725141 NPI number is provided on an as is basis without warranty of any kind. 1154725141 is maintained by the National Plan & Provider Enumeration System. The contents of Racinmd Llc are for informational purposes only.