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Specialty details in registry · Mattapan, MA

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At a glance

93 W Selden St, Mattapan, MA 02126

NPPES record updated Apr 30, 2015. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

93 W Selden St
Mattapan, MA 02126
Professional details: NPI, taxonomy & registry record
NPI1033596895
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
347E00000X
Enumeration date
Apr 30, 2015
Record updated
Apr 30, 2015
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

347E00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

93 W Selden St
Mattapan, MA 02126
Phone
(978) 905-5005
Fax
(617) 696-2915
Mailing address
93 W SELDEN ST

MATTAPAN, MA 02126
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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