| East Boston Behavioral Health And Medicine Llc | |
|
464 Bremen St Ste 4 East Boston MA 02128-1430 | |
| (617) 567-9200 | |
| (617) 567-9300 |
| Full Name | East Boston Behavioral Health And Medicine Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 464 Bremen St Ste 4, East Boston, Massachusetts |
| Authorized Official Name and Position | Sabina Ferreira Tavares (CEO) |
| Authorized Official Contact | 6175679200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Boston Behavioral Health And Medicine Llc 464 Bremen St Ste 4 East Boston MA 02128-1430 Ph: (617) 359-2146 | East Boston Behavioral Health And Medicine Llc 464 Bremen St Ste 4 East Boston MA 02128-1430 Ph: (617) 567-9200 |
| NPI Number | 1669096996 |
|---|---|
| Provider Enumeration Date | 06/02/2020 |
| Last Update Date | 10/16/2020 |
| Certification Date | 10/16/2020 |
| Medicare PECOS PAC ID | 3577977040 |
|---|---|
| Medicare Enrollment ID | O20210123000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669096996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sabina Tavares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477064293 PECOS PAC ID: 8022377522 Enrollment ID: I20180108002935 |
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