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General NPI Number Information
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NPI Number | 1225826712
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Entity Type | Organization
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Legal Business Name | WHSP MEDICAL PC
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 20 GUEST ST STE 200
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City | BRIGHTON
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State | MA
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Zip | 02135-2040
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Country | US
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Telephone | 215-694-7158
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Fax |
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Provider Business Mailing Address
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Address Line | 20 GUEST ST STE 200
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City | BRIGHTON
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State | MA
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Zip | 02135-2040
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHRYN E ACKERMAN
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Credential | MD
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Telephone | 215-694-7158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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