| Datta Consultants Llc | |
| 
					132 Rosalie Rd Newton Center MA 02459-3153  | |
| (617) 548-0184 | |
| (617) 609-7636 | 
| Full Name | Datta Consultants Llc | 
|---|---|
| Speciality | Psychiatry & Neurology | 
| Location | 132 Rosalie Rd, Newton Center, Massachusetts | 
| Authorized Official Name and Position | Datta Gouri (OWNER/PSYCHIATRIST) | 
| Authorized Official Contact | 6175480184 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Datta Consultants Llc 132 Rosalie Rd Newton Center MA 02459-3153 Ph: (617) 548-0184  | Datta Consultants Llc 132 Rosalie Rd Newton Center MA 02459-3153 Ph: (617) 548-0184  | 
| NPI Number | 1316675275 | 
|---|---|
| Provider Enumeration Date | 08/09/2022 | 
| Last Update Date | 08/09/2022 | 
| Certification Date | 08/09/2022 | 
| Medicare PECOS PAC ID | 7214389345 | 
|---|---|
| Medicare Enrollment ID | O20240115000155 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1316675275 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary | 
| Provider Name | Gouri Datta | 
|---|---|
| Provider Type | Practitioner - Neuropsychiatry | 
| Provider Identifiers | NPI Number: 1528054889 PECOS PAC ID: 5395704522 Enrollment ID: I20041018000367  | 
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