Healthcare Provider Details

I. General information

NPI: 1710379433
Provider Name (Legal Business Name): DOWNES THERPEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 PINE ST
NATICK MA
01760-1332
US

IV. Provider business mailing address

169 PINE ST
NATICK MA
01760-1332
US

V. Phone/Fax

Practice location:
  • Phone: 508-647-0100
  • Fax: 508-647-0103
Mailing address:
  • Phone: 508-647-0100
  • Fax: 508-647-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number32897
License Number StateMA

VIII. Authorized Official

Name: DR. ROBERT BARRY DOWNES
Title or Position: OWNER/ SOLE PROPRIETOR
Credential: M.D.
Phone: 508-647-0100