Healthcare Provider Details

I. General information

NPI: 1194620138
Provider Name (Legal Business Name): NEW SEASON PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 MASSACHUSETTS AVE
BOXBOROUGH MA
01719-2223
US

IV. Provider business mailing address

1740 MASSACHUSETTS AVE
BOXBOROUGH MA
01719-2223
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone: 508-479-6032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MATTHEW MICHAEL PECULIS
Title or Position: OWNER
Credential: PMHNP
Phone: 508-479-6032