Healthcare Provider Details

I. General information

NPI: 1427197896
Provider Name (Legal Business Name): JAIMEE TUREK NEWCOMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WARREN ST BOSTON COMM LEADERSHIP ACADEMY
BRIGHTON MA
02135
US

IV. Provider business mailing address

1010 MASSACHUSETTS AVENUE
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-534-2023
  • Fax: 617-534-2024
Mailing address:
  • Phone: 617-534-2398
  • Fax: 617-534-4688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number212481
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: