Healthcare Provider Details

I. General information

NPI: 1548768435
Provider Name (Legal Business Name): EKATERINA FILATOV PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD MA
02062-4649
US

IV. Provider business mailing address

1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD MA
02062-4649
US

V. Phone/Fax

Practice location:
  • Phone: 508-206-8578
  • Fax: 866-470-6528
Mailing address:
  • Phone: 508-206-8578
  • Fax: 866-470-6528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2277004
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2277004
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: