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General NPI Number Information
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NPI Number | 1285803213
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Entity Type | Organization
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Legal Business Name | MT AUBURN HOSPITAL DEPT OF PSYCHIATRY
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 05/05/2024
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Provider Practice Location Address
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Address Line | 330 MOUNT AUBURN ST CLARK 1
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City | CAMBRIDGE
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State | MA
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Zip | 02138-5502
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Country | US
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Telephone | 617-499-5054
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Fax | 617-499-5065
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Provider Business Mailing Address
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Address Line | 1 ARSENAL MARKET PL
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City | WATERTOWN
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State | MA
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Zip | 02472-5018
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Country | US
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Telephone | 617-673-1851
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Fax | 617-499-5579
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Authorized Official
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Title or Position | CFO
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Name | MR. BRIAN SMITH
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Credential |
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Telephone | 405-245-6238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 2898
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License Number State | MA
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