AMBAMA CLINIC PC (NPI# 1205992989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205992989 |
| Entity Type | Organization |
| Organization Name | AMBAMA CLINIC PC |
| Practice Address |
56 Cottage Grove Ave Brockton MA 02301-6347 |
| Practice Telephone | 6172960720 |
| Practice Fax Number | 6172965166 |
| Mailing Telephone | 6172960720 |
| Mailing Fax Number | 6172965166 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2008-01-18 |
| Authorized Official Name | DR. ASHOK J PATEL (MANAGER) |
| Authorized Official Telephone | 6172960720 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0000X |
Internal Medicine Specialization: Adolescent Medicine |
52194 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS HEALTH PLAN | 697380 | 01 |
| MA | BLUE CROSS BLUE SHIELD MA | M18330 | 01 |
| MA | 9728350 | 05 | |
| MA | RAILROAD MEDICARE GROUP | DA4008 | 01 |
| MA | NEIGHBORHOOD HEALTH PLAN | 0030542 | 01 |
| Street Address |
56 COTTAGE GROVE AVE |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-6347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 207RA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174545875 | Partners Community Physicians Organization Inc | Internal Medicine | 80 Beharrell St, Concord, MA 01742-1739 | 2006-07-24 |
| 1396714499 | Lynn Ellen Jumper | Internal Medicine | 727 Main St, Melrose, MA 02176 | 2006-03-14 |
| 1326039603 | Ellen Senghas | Internal Medicine | 76b Carlon Dr, Northampton, MA 01060-2373 | 2005-11-04 |
| 1154317089 | Spyridon Kantas | Internal Medicine | 63 Park Street, Andover, MA 01810 | 2005-09-26 |
| 1588824601 | Kathleen Townes | Internal Medicine | 36 Essex Rd, Lahey Ipswich, Ipswich, MA 01938-2599 | 2008-06-12 |
| 1821258179 | Bryon A. Gentile | Internal Medicine | 55 Lake Ave N, Worcester, MA 01655-0002 | 2008-06-11 |
| 1427186428 | Ashish Gandhi Md PC | Internal Medicine | 451 Andover St Ste G11, North Andover, MA 01845 | 2007-03-01 |
| 1093840779 | Thomas I. Nary | Internal Medicine | 140 Commonwealth Ave, Boston College Health Services Cushing Hall, Chestnut Hill, MA 02467-3800 | 2007-02-22 |
| 1780761312 | Jonathan M Mansbach | Internal Medicine | 300 Longwood Ave, Boston, MA 02115-5724 | 2006-11-01 |
| 1245315290 | Kalpna Thuraisamy | Internal Medicine | 269 Chatham Rd, Harwich, MA 02645-3309 | 2006-10-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AMBAMA CLINIC PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.