MEDICARE: CENTRAL MASS BEHAVIORAL HEALTH

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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1902397128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL MASS BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	57 E MAIN ST STE 209
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1445
Country	:	US
Telephone Number	:	508-529-0576
Fax Number	:	617-581-6040

Provider Business Practice Location Address
First Line	:	57 E MAIN ST STE 209
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1445
Country	:	US
Telephone Number	:	508-529-0576
Fax Number	:

Authorized Official
Title or Position	:	MD/OWNER
Name	:	RIFAT SHARIF
Credential	:	MD
Telephone Number	:	508-529-0576

Provider Enumeration Date	:	05/23/2018
Last Update Date	:	05/23/2018

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