Codman Square Health Center

NPI #1437328648 in Dorchester, Massachusetts

Provider Information

NPI Number: 1437328648
Entity Type: Organization
Organization Name: Codman Square Health Center
Subpart: Yes (part of a larger organization)
Parent Organization: CODMAN SQUARE HEALTH CENTER
Primary Specialty: Optometrist
Enumeration Date: Feb 22, 2008
Last Updated: Feb 22, 2008

Practice Location

Address: 637 WASHINGTON STREET
City: Dorchester
State: Massachusetts
ZIP Code: 02124
Phone: (617) 825-9660

Authorized Official

Name: PHILIP SEVERIN, MD
Title: MEDICAL DIRECTOR
Phone: (617) 825-9660

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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