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General NPI Number Information
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NPI Number | 1639063597
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Entity Type | Organization
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Legal Business Name | NEW SEASON PSYCHIATRY
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 300 BAKER AVENUE SUITE 300 - #1102
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City | CONCORD
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State | MA
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Zip | 01742
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Country | US
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Telephone | 978-245-7492
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Fax | 469-373-3110
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Provider Business Mailing Address
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Address Line | 300 BAKER AVENUE SUITE 300 - #1102
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City | CONCORD
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State | MA
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Zip | 01742
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Country | US
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Telephone | 978-245-7492
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Fax | 469-373-3110
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW MICHAEL PECULIS
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Credential | CNP, PMHNP
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Telephone | 508-479-6032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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