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General NPI Number Information
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NPI Number | 1780249292
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL PEDIATRICS OF GREATER BOSTON, LLC
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 100 HIGH ST STE 200
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City | WESTWOOD
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State | MA
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Zip | 02090-1100
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Country | US
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Telephone | 781-856-6530
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Fax |
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Provider Business Mailing Address
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Address Line | 100 HIGH ST STE 200
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City | WESTWOOD
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State | MA
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Zip | 02090-1100
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Country | US
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Telephone | 781-856-6530
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Fax | 781-449-0580
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Authorized Official
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Title or Position | MD
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Name | DR. NAOMI B GERSHON
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Credential | MD
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Telephone | 781-856-6530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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