Beaver Brook Pediatric & Adolescent Medicine, P.c.
Pediatric Adolescent Medicine
Beaver Brook Pediatric & Adolescent Medicine, P.c. is a Waltham, Massachusetts based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
465 Waverley Oaks Rd, Suite 100, Waltham, Massachusetts - 02452-8438. They can be contacted on phone at
781-891-3706 and fax number 781-891-3564.
NPI number (Unique professional ID) for Beaver Brook Pediatric & Adolescent Medicine, P.c. is
1235180100 which was assigned by NPPES on 15 May, 2006 and it was last updated on 21 Jan, 2020.
Beaver Brook Pediatric & Adolescent Medicine, P.c. specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Beaver Brook Pediatric & Adolescent Medicine, P.c. basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Beaver Brook Pediatric & Adolescent Medicine, P.c. |
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Business Address:
Beaver Brook Pediatric & Adolescent Medicine, P.c. address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 465 Waverley Oaks Rd, Suite 100
Waltham, MA, 02452-8438
United States |
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| Phone Number : | 781-891-3706 |
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| Fax Number : | 781-891-3564 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1235180100 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 15 May, 2006 |
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| Last Updated On : | 21 Jan, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Janetl Antonioni |
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| Official Title or Position : | OWNER/PROVIDER |
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| Phone Number : | 781-891-3706 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Beaver Brook Pediatric & Adolescent Medicine, P.c. are as mentioned. Primary taxonomy code for Beaver Brook Pediatric & Adolescent Medicine, P.c. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Beaver Brook Pediatric & Adolescent Medicine, P.c. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 110074250A | MEDICAID | MA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 465 Waverley Oaks Rd, Suite 100
Waltham, MA, 02452-8438
United States |
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| Phone Number : | 781-891-3706 |
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| Fax Number : | 781-891-3564 |
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Business Location:
Patients can refer following map for directions to
Beaver Brook Pediatric & Adolescent Medicine, P.c. practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.