Beaver Brook Pediatric & Adolescent Medicine, P.C.

LBN: Beaver Brook Pediatric & Adolescent Medicine, P.C.
Beaver Brook Pediatric & Adolescent Medicine, P.C. is an health care organization with primary practice located at 465 Waverley Oaks Rd Suite 100, Waltham MA 02452-8438. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Beaver Brook Pediatric & Adolescent Medicine, P.C. can be contacted via phone (781) 891-3706, or through Antonioni, Janet L via phone (781) 891-3706.

Contact Information

Primary practice address
465 Waverley Oaks Rd Suite 100 Waltham MA 02452-8438
Phone: (781) 891-3706
Fax: (781) 891-3564
Website:
Map and Directions
Authorized official contact:
Name: Antonioni, Janet L
Phone: (781) 891-3706

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X

Profile Details

NPI number 1235180100
LBN Legal business name Beaver Brook Pediatric & Adolescent Medicine, P.C.
DBA Doing business as
Authorized official Antonioni, Janet L
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2006
Last updated Jan 21st, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235180100 NPPES
Massachusetts MEDICAID 110074250A

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