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General NPI Number Information
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NPI Number | 1275734535
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Entity Type | Organization
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Legal Business Name | MARLBOROUGH CENTER FOR SLEEP DISORDERS
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 320 BOLTON ST SUITE 100
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City | MARLBOROUGH
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State | MA
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Zip | 01752-3980
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Country | US
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Telephone | 508-481-4288
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Fax | 508-624-7228
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Provider Business Mailing Address
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Address Line | 320 BOLTON ST SUITE 100
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City | MARLBOROUGH
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State | MA
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Zip | 01752-3980
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Country | US
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Telephone | 508-481-4288
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Fax | 508-624-7228
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Authorized Official
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Title or Position | OWNER
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Name | DR. CLIFFORD GEORGE RISK
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Credential | M.D.,PH.D.
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Telephone | 508-481-4288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 47576
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License Number State | MA
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