Square Medical Group LLC
Clinic/Center, Adult Mental Health in Watertown, MA. Organization (NPI-2).
NPI number1356515464
StatusActive
Last updated in NPPESAug 13, 2015
Details
- NPI
- 1356515464
- Entity type
- Organization (NPI-2)
- Legal business name
- Square Medical Group LLC
- Organization subpart
- No
- Enumeration date
- Apr 18, 2008
- Last updated
- Aug 13, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | 152859 | MA | Yes |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | 152859 | MA |
Practice location
124 Watertown StSuite 2d
Watertown, MA 02472-2576
Phone 617-916-5069 · Fax 617-467-4073
Mailing address
124 Watertown StSuite 2d
Watertown, MA 02472-2576
Phone 617-916-5069 · Fax 617-467-4073
Authorized official
Natalie Leonid Lender
Medical Director, Owner
6179165069
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