Provider Demographics
NPI:1447808431
Name:BOSTON CENTER FOR CLINICAL RESEARCH LLC
Entity type:Organization
Organization Name:BOSTON CENTER FOR CLINICAL RESEARCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:KINRYS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-244-3322
Mailing Address - Street 1:246 WALNUT ST STE 104
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1639
Mailing Address - Country:US
Mailing Address - Phone:617-244-3322
Mailing Address - Fax:617-581-6040
Practice Address - Street 1:67 UNION ST STE 203
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:617-244-3322
Practice Address - Fax:617-581-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty