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General NPI Number Information
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NPI Number | 1205231941
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Entity Type | Organization
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Legal Business Name | BOSTON PUBLIC HEALTH COMMISSION
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 25 JAMES ONEILL ST
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City | SOUTH BOSTON
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State | MA
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Zip | 02127-4504
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Country | US
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Telephone | 617-534-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 MASSACHUSETTS AVE
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City | BOSTON
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State | MA
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Zip | 02118-2600
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Country | US
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Telephone | 617-534-5264
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE
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Name | JUDITH MARTINEZ
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Credential |
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Telephone | 617-534-4222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 4YHQ
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License Number State | MA
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