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Contact Information

LONGEVITY GROUP LLC
76 N BEDFORD ST UNIT A-4
EAST BRIDGEWATER, MA02333-1182
 Phone: 598-484-3251
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Licensed Psychiatric Technician

167G00000X
 

Psychosomatic Medicine

2084P0015X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for LONGEVITY GROUP LLC · (Female)

NPI Number 1124535729
Status Active
Credentials
Entity Individual
Enumeration date 01/04/2018
Last updated 06/16/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • MA License # 233962
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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