Provider Demographics
NPI:1205903721
Name:ROTHFELD CENTER FOR INTEGRATIVE MEDICINE
Entity type:Organization
Organization Name:ROTHFELD CENTER FOR INTEGRATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:781-641-1901
Mailing Address - Street 1:180 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8448
Mailing Address - Country:US
Mailing Address - Phone:781-641-1901
Mailing Address - Fax:781-641-3963
Practice Address - Street 1:180 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8448
Practice Address - Country:US
Practice Address - Phone:781-641-1901
Practice Address - Fax:781-641-3963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty