Provider Demographics
NPI:1578140430
Name:MAKEIT NEUROTHERAPEUTICS
Entity Type:Organization
Organization Name:MAKEIT NEUROTHERAPEUTICS
Other - Org Name:EMK NEUROTHERAPEUTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD MENG
Authorized Official - Phone:617-981-9332
Mailing Address - Street 1:224 CLARENDON ST STE 22
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3795
Mailing Address - Country:US
Mailing Address - Phone:617-981-9332
Mailing Address - Fax:
Practice Address - Street 1:224 CLARENDON ST STE 22
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3795
Practice Address - Country:US
Practice Address - Phone:617-652-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty