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General NPI Number Information
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NPI Number | 1942819784
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Entity Type | Organization
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Legal Business Name | BLUESKY TELEPSYCH, INC.
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 125 CAMBRIDGE PARK DRIVE SUITE 306
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City | CAMBRIDGE
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State | MA
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Zip | 02140
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Country | US
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Telephone | 888-279-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 135 SE MARTIN AVE
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City | STUART
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State | FL
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Zip | 34996-1213
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NATALIA KULACH
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Credential |
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Telephone | 888-279-0002
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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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