South Cape Psychiatric Services PLLC
Nurse Practitioner, Psych/Mental Health in Waquoit, MA. Organization (NPI-2).
NPI number1669901807
StatusActive
Last updated in NPPESNov 16, 2017
Details
- NPI
- 1669901807
- Entity type
- Organization (NPI-2)
- Legal business name
- South Cape Psychiatric Services PLLC
- Organization subpart
- No
- Enumeration date
- Jun 10, 2017
- Last updated
- Nov 16, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | RN2267688 | MA | Yes |
Practice location
446 Waquoit HwyWaquoit, MA 02536-5522
Phone 774-255-5010
Mailing address
312 Red Brook RdMashpee, MA 02649-3761
Phone 617-957-8063
Authorized official
David Jaffe
Nurse Practitioner
6179578063
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