Provider Demographics
NPI:1962636753
Name:PYRAMID BUILDER ASSOCIATES
Entity Type:Organization
Organization Name:PYRAMID BUILDER ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:THESATUS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:508-580-1289
Mailing Address - Street 1:480 CHATHAM WEST DR
Mailing Address - Street 2:480 CHATHAM WEST
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1322
Mailing Address - Country:US
Mailing Address - Phone:508-580-1289
Mailing Address - Fax:
Practice Address - Street 1:480 CHATHAM WEST DR
Practice Address - Street 2:480 CHATHAM WEST
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1322
Practice Address - Country:US
Practice Address - Phone:508-580-1289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health