| Square Medical Group Llc | |
|
124 Watertown St Ste 2d Watertown MA 02472-2599 | |
| (617) 916-5069 | |
| Not Available |
| Full Name | Square Medical Group Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 124 Watertown St Ste 2d, Watertown, Massachusetts |
| Authorized Official Name and Position | Jeff Gershman (CEO) |
| Authorized Official Contact | 6179165069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Square Medical Group Llc 124 Watertown St Ste 2d Watertown MA 02472-2599 Ph: (617) 916-5069 | Square Medical Group Llc 124 Watertown St Ste 2d Watertown MA 02472-2599 Ph: (617) 916-5069 |
| NPI Number | 1760957609 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 10/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760957609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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