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General NPI Number Information
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NPI Number | 1881773158
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Entity Type | Organization
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Legal Business Name | HILLSIDE ASSOCIATES LLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 77 WARREN ST BLDG 2, 3RD FLOOR
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City | BRIGHTON
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State | MA
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Zip | 02135-3601
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Country | US
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Telephone | 617-787-4662
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Fax | 617-787-4662
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Provider Business Mailing Address
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Address Line | 77 WARREN ST BLDG 2, 3RD FLOOR
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City | BRIGHTON
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State | MA
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Zip | 02135-3601
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Country | US
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Telephone | 617-787-4662
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Fax | 617-787-4662
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BETTY HERR
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Credential | M.D.
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Telephone | 617-787-4662
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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 | 45781
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License Number State | MA
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