Provider Demographics
NPI:1710379433
Name:DOWNES THERPEUTICS LLC
Entity Type:Organization
Organization Name:DOWNES THERPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:DOWNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-647-0100
Mailing Address - Street 1:169 PINE ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1332
Mailing Address - Country:US
Mailing Address - Phone:508-647-0100
Mailing Address - Fax:508-647-0103
Practice Address - Street 1:169 PINE ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1332
Practice Address - Country:US
Practice Address - Phone:508-647-0100
Practice Address - Fax:508-647-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32897261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE55034Medicaid