Provider Demographics
NPI:1013535632
Name:ALZHEIMERS DISEASE CENTER
Entity Type:Organization
Organization Name:ALZHEIMERS DISEASE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-639-5006
Mailing Address - Street 1:PO BOX 45555
Mailing Address - Street 2:
Mailing Address - City:WINTER HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02145-0009
Mailing Address - Country:US
Mailing Address - Phone:617-639-5006
Mailing Address - Fax:
Practice Address - Street 1:54 MILLER ST FL 4
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4725
Practice Address - Country:US
Practice Address - Phone:617-302-6388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty