Healthcare Provider Details

I. General information

NPI: 1013986694
Provider Name (Legal Business Name): MILTON PEDIATRIC ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 WOOD ROAD SUITE 301
BRAINTREE MA
02184
US

IV. Provider business mailing address

340 WOOD ROAD SUITE 301
BRAINTREE MA
02184
US

V. Phone/Fax

Practice location:
  • Phone: 781-356-6200
  • Fax: 781-356-6299
Mailing address:
  • Phone: 781-356-6200
  • Fax: 781-356-6299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA NILOFF
Title or Position: CMO
Credential: MD
Phone: 781-356-6200