Healthcare Provider Details

I. General information

NPI: 1457545006
Provider Name (Legal Business Name): NESCA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 BRIDGE ST
NEWTON MA
02458-1119
US

IV. Provider business mailing address

90 BRIDGE ST
NEWTON MA
02458-1119
US

V. Phone/Fax

Practice location:
  • Phone: 617-658-9800
  • Fax:
Mailing address:
  • Phone: 617-658-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: ANN HELMUS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 617-641-0900