Provider Demographics
NPI:1821304395
Name:NEPONSET HEALTH CENTER
Entity Type:Organization
Organization Name:NEPONSET HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-533-2350
Mailing Address - Street 1:105 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2201
Mailing Address - Country:US
Mailing Address - Phone:781-461-1434
Mailing Address - Fax:
Practice Address - Street 1:1135 MORTON ST
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2834
Practice Address - Country:US
Practice Address - Phone:617-533-2350
Practice Address - Fax:617-533-2351
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARBOR HEALTH SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN151563261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health