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General NPI Number Information
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NPI Number | 1821304395
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Entity Type | Organization
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Legal Business Name | NEPONSET HEALTH CENTER
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 1135 MORTON ST
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City | MATTAPAN
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State | MA
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Zip | 02126-2834
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Country | US
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Telephone | 617-533-2350
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Fax | 617-533-2351
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Provider Business Mailing Address
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Address Line | 105 CANTON ST
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City | WESTWOOD
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State | MA
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Zip | 02090-2201
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Country | US
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Telephone | 781-461-1434
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. ROBERT A. HOCH
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Credential | MD
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Telephone | 617-533-2350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | RN151563
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License Number State | MA
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