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NPI Code Detail

MEDICARE: SUBURBAN PSYCHIATRIC SPECIALISTS PC

MEDICARE: SUBURBAN PSYCHIATRIC SPECIALISTS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2103T00000XPsychologist
3261QM0850XAdult Mental Health Clinic/Center
42084P0015XPsychosomatic Medicine Physician
52084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1073374534
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUBURBAN PSYCHIATRIC SPECIALISTS PC
Provider Business Mailing Address
First Line : 1500 BOSTON PROVIDENCE TPKE STE 20
Second Line :
City : NORWOOD
State : MA
Zip : 02062-4649
Country : US
Telephone Number : 508-206-8578
Fax Number :
Provider Business Practice Location Address
First Line : 1500 BOSTON PROVIDENCE TPKE STE 20
Second Line :
City : NORWOOD
State : MA
Zip : 02062-4649
Country : US
Telephone Number : 508-206-8578
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : UJALA FAWAD
Credential : MD
Telephone Number : 508-206-8578
Provider Enumeration Date : 01/22/2024
Last Update Date : 06/23/2025

Similar Medicare Providers

1063662112 — DR. UJALA FAWAD M.D.
Practice Location Address:
1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD, MA
02062-4649
Practice Phone: 508-206-8578
Practice Fax:
1184904146 — USAMA FEROZE M.D.
Practice Location Address:
1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD, MA
02062-4649
Practice Phone: 508-206-8578
Practice Fax: 866-470-6528
1548768435 — EKATERINA FILATOV PMHNP
Practice Location Address:
1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD, MA
02062-4649
Practice Phone: 508-206-8578
Practice Fax: 866-470-6528
1881233203 — JENNIFER A KANIA PMHNP
Practice Location Address:
1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD, MA
02062-4649
Practice Phone: 508-206-8578
Practice Fax: 866-470-6528
1447874284 — SUBURBAN PSYCHIATRIC SPECIALISTS PC
Practice Location Address:
1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD, MA
02062-4649
Practice Phone: 508-205-9628
Practice Fax:
1265188395 — LEAH MONIQUE HASTINGS PMHNP -BC
Practice Location Address:
1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD, MA
02062-4649
Practice Phone: 508-206-8578
Practice Fax: 866-470-6528

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