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General NPI Number Information
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NPI Number | 1710015854
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Entity Type | Individual
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Provider Name | MR. THOMAS N BAROUK
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 340 MAIN ST SUITE 503 CEDAR ST FAMLIY CLINIC
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City | WORCESTER
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State | MA
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Zip | 01608
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Country | US
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Telephone | 508-926-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 81 GROVE ST
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City | PAXTON
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State | MA
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Zip | 01612
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Country | US
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Telephone | 508-868-5831
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Fax | 508-798-3497
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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