Provider Demographics
NPI:1013187707
Name:NETO, ENEDINO RB
Entity Type:Individual
Prefix:MR
First Name:ENEDINO
Middle Name:RB
Last Name:NETO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 WEST WYOMING AVE.
Mailing Address - Street 2:APT. 22
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3749
Mailing Address - Country:US
Mailing Address - Phone:781-608-3529
Mailing Address - Fax:
Practice Address - Street 1:56 W WYOMING AVE
Practice Address - Street 2:APT. 22
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3766
Practice Address - Country:US
Practice Address - Phone:781-608-3529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker