Healthcare Provider Details

I. General information

NPI: 1154713030
Provider Name (Legal Business Name): NEW ENGLAND CENTER FOR PSYCHIATRIC AND ADDICTION DISORDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 PARK ST
ATTLEBORO MA
02703-2338
US

IV. Provider business mailing address

24 PARK ST
ATTLEBORO MA
02703-2338
US

V. Phone/Fax

Practice location:
  • Phone: 508-222-0089
  • Fax: 508-222-0095
Mailing address:
  • Phone: 508-222-0089
  • Fax: 508-222-0095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number71995
License Number StateMA

VIII. Authorized Official

Name: DR. ILEANA BERMAN
Title or Position: OWNER
Credential: M.D.
Phone: 401-447-9611