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General NPI Number Information
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NPI Number | 1972253516
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Entity Type | Organization
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Legal Business Name | PRIVATE HEALTH HUB LLC
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Dates
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Enumeration Date | 03/26/2022
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 267 MOODY ST STE 207
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City | WALTHAM
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State | MA
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Zip | 02453-5238
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Country | US
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Telephone | 781-312-5450
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 541157
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City | WALTHAM
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State | MA
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Zip | 02454-1157
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Country | US
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Telephone | 781-312-5450
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. FREDERICK BALAGADDE
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Credential |
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Telephone | 781-296-5444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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