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NPI Code Detail

MEDICARE: BASSEL THAIER TUFFAHA

MEDICARE:   BASSEL THAIER TUFFAHA
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1841172632
Entity Type Code : Individual
Provider Name (Legal Business Name) : BASSEL THAIER TUFFAHA
Provider Business Mailing Address
First Line : 124 GROVER ROAD EXT
Second Line :
City : MEDFORD
State : MA
Zip : 02155-1900
Country : US
Telephone Number : 617-650-7545
Fax Number :
Provider Business Practice Location Address
First Line : 450 BEDFORD ST STE 2400
Second Line :
City : LEXINGTON
State : MA
Zip : 02420-1544
Country : US
Telephone Number : 781-633-7779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2025
Last Update Date : 07/22/2025

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Directions to “ BASSEL THAIER TUFFAHA ” Practice Location

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