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General NPI Number Information
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NPI Number | 1194031799
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Entity Type | Organization
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Legal Business Name | CENTER FOR PSYCHIATRIC MEDICINE PC
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 451 ANDOVER ST STE 205
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-5079
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Country | US
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Telephone | 781-259-0865
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Fax |
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Provider Business Mailing Address
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Address Line | 451 ANDOVER ST STE 205
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-5079
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Country | US
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Telephone | 781-259-0865
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Fax |
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Authorized Official
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Title or Position | SHAREHOLDER/OFFICER
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Name | MR. THOMAS MCLAUGHLIN
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Credential | M.D.
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Telephone | 781-259-0865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 53828
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License Number State | MA
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