AMBAMA CLINIC PC NPI 1205992989

NPI Information

NPI: 1205992989
Provider Name: AMBAMA CLINIC PC
Classification: Internal Medicine - 207RA0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
56 COTTAGE GROVE AVE
BROCKTON, MA
ZIP 02301
Phone: (617) 296-0720
Get Directions

AMBAMA CLINIC PC is an adolescent medicine internal medicine in Brockton, MA. The provider is 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. AMBAMA CLINIC PC NPI is 1205992989. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

56 COTTAGE GROVE AVE
BROCKTON, MA
ZIP 02301-347
Phone: (617) 296-0720
Fax: (617) 296-5166

The provider's authorized official is Ashok J Patel .
The authorized official title is Manager and has the following contact phone number (617) 296-0720.

The enumeration date for this NPI number is 12/28/2006 and was last updated on 1/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RA0000X	Internal Medicine	Adolescent Medicine	52194	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0030542	OTHER	MASSACHUSETTS	NEIGHBORHOOD HEALTH PLAN
2	9728350	MEDICAID	MASSACHUSETTS
3	DA4008	OTHER	MASSACHUSETTS	RAILROAD MEDICARE GROUP
4	M18330	OTHER	MASSACHUSETTS	BLUE CROSS BLUE SHIELD MA
5	F80450	MEDICARE UPIN	MASSACHUSETTS
6	697380	OTHER	MASSACHUSETTS	TUFTS HEALTH PLAN
7	M21353	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS	MEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »