National Provider Identifier Database

AMBAMA CLINIC PC
Adolescent Medicine

An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.


Contact Information

AMBAMA CLINIC PC
56 COTTAGE GROVE AVE
BROCKTON, MA02301-6347
Phone: 617-296-0720
Fax: 617-296-5166
Website:
Specialty Taxonomy Code
* Adolescent Medicine 207RA0000X

* Indicates primary specialty

NPI Profile & details for AMBAMA CLINIC PC

NPI Number 1205992989
Legal business name
LBN
AMBAMA CLINIC PC
Authorized official ASHOK PATEL - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 12/28/2006
Last updated 01/18/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • MA License #: 52194
  • MA Medicaid: 9728350
  • MA Other: M18330 BLUE CROSS BLUE SHIELD MA
  • MA Other: 0030542 NEIGHBORHOOD HEALTH PLAN
  • MA Other: DA4008 RAILROAD MEDICARE GROUP
  • MA Other: 697380 TUFTS HEALTH PLAN

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.

Reviews for AMBAMA CLINIC PC

There are currently no reviews for AMBAMA CLINIC PC


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