Provider Demographics
NPI:1043548233
Name:ABODE L. HAMOUSH, MD, PC
Entity type:Organization
Organization Name:ABODE L. HAMOUSH, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABODE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMOUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FASAM
Authorized Official - Phone:617-584-1315
Mailing Address - Street 1:143 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-3807
Mailing Address - Country:US
Mailing Address - Phone:617-584-1315
Mailing Address - Fax:
Practice Address - Street 1:143 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3807
Practice Address - Country:US
Practice Address - Phone:617-584-1315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-27
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226719251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health