Healthcare Provider Details

I. General information

NPI: 1992864599
Provider Name (Legal Business Name): PSYCHIATRIC GROUP OF THE NORTH SHORE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 LYNNWAY SUITE 101
LYNN MA
01901
US

IV. Provider business mailing address

330 LYNNWAY SUITE 101
LYNN MA
01901
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-3003
  • Fax: 781-593-0071
Mailing address:
  • Phone: 781-595-3003
  • Fax: 781-593-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. YOSHIHARA AKABANE
Title or Position: PRESIDENT PGNS
Credential: MD
Phone: 781-595-3003