Healthcare Provider Details

I. General information

NPI: 1053148890
Provider Name (Legal Business Name): EMPATH MEDICINE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 BISHOP ALLEN DR STE 5
CAMBRIDGE MA
02139-2499
US

IV. Provider business mailing address

5019 NOOR PARK CIR
DUBLIN OH
43016-7075
US

V. Phone/Fax

Practice location:
  • Phone: 617-410-6069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIAM ABOUKAR
Title or Position: CEO
Credential: DO
Phone: 614-446-0500