| Organization Name: | MT AUBURN PROFESSIONAL SERVICES |
| NPI Number: | 1013375203 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM SULLIVAN (CFO) |
| Mailing Address: | 725 Concord Ave Suite 4100 Cambridge |
| State: | MA US |
| Postal Code: | 021381040 |
| Phone Number: | 6178648822 |
| Fax Number: | 6175475367 |
| NPI Enumeration Date: | 02/03/2016 |
| NPI Last Update Date: | 02/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207LA0401X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Anesthesiology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | An anesthesiologist who specializes in the diagnosis and treatment of addictions. |