SOUTHBORO MEDICAL GROUP, INC.


Address: 24 Newton St, Southborough, MA 01772-1215
Phone: 5084815500

SOUTHBORO MEDICAL GROUP, INC. (NPI# 1518032630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518032630
Entity Type Organization
Organization Name SOUTHBORO MEDICAL GROUP, INC.
Practice Address 24 Newton St
Southborough
MA 01772-1215
Practice Telephone 5084815500
Practice Fax Number 5084603025
Mailing Telephone 5084815500
Mailing Fax Number 5084603025
Enumeration Date 2006-11-22
Last Update Date 2020-08-22
Authorized Official Name MARVIN OSTROVSKY (PRESIDENT)
Authorized Official Telephone 5084815500
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 103T00000X Psychologist Behavioral Health & Social Service Providers
X 1041C0700X Social Worker
Specialization: Clinical
Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MA TUFTS BEHAVIORAL HEALTH 669105 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1578637724 Southboro Medical Group, Inc. Optometrist 24 Newton St, Southborough, MA 01772-1215 2006-11-20
1568473635 Southboro Medical Group, Inc. Social Worker 24 Newton St, Southborough, MA 01772-1215 2006-08-11

Office Location

Street Address 24 NEWTON ST
City SOUTHBOROUGH
State MA
Zip Code 01772-1215

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922094788 Mark Finno, Md PC Physical Medicine & Rehabilitation 24 Newton St, Southborough, MA 01772-1215 2005-09-26
1649881699 Jeremy Kw Spiewak Pharmacist 24 Newton St, Southborough, MA 01772-1215 2020-08-13
1437794716 Reliant Medical Group, Inc Optometrist 24 Newton St, Southborough, MA 01772-1215 2019-11-11
1427516004 Fnu Jomymerlythomas Physical Therapist 24 Newton St, Southborough, MA 01772-1215 2019-03-04
1629558960 Amanda N Griffin Nurse Practitioner 24 Newton St, Southborough, MA 01772-1215 2018-08-16
1700322674 Rosalind Gendreau Registered Nurse 24 Newton St, Southborough, MA 01772-1215 2017-01-16
1932584950 Christine Ditullio Nurse Practitioner 24 Newton St, Southborough, MA 01772-1215 2015-07-21
1891175113 Elizabeth Ann Minevich Internal Medicine 24 Newton St, Southborough, MA 01772-1215 2015-06-02
1164834750 Southboro Medical Group, Inc Specialist 24 Newton St, Southborough, MA 01772-1215 2014-05-30
1588096754 Shannon Leah Devlin Registered Nurse 24 Newton St, Southborough, MA 01772-1215 2013-07-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043854391 Hiral Patel Pharmacist 150 Northnoro Road, Suite 4, Southborough, MA 01772 2019-10-30
1588188544 Jennifer Foran Behavior Technician 33 Turnkpike Road, Southborough, MA 01772 2017-08-01
1588184402 Lise Mary Gallo Behavioral Analyst 16 Clifford St, Southborough, MA 01772 2017-06-21
1437508322 Kristen Lomker Pharmacist 155 Northborough Rd, Southboro, MA 01772 2016-06-10
1679841829 Scott Adam Canter Acupuncturist 64 William Onthank Lane, Southborough, MA 01772 2011-12-02
1396966206 Umer Sayeed Shah Surgery 2 Parkcentral Drive Suite 210, Avc / Acc, Southborough, MA 01772 2007-05-01
1982636411 Armineh Mirzabegian Internal Medicine Southboro Medical Group, 24 Newton Street, Southboro, MA 01772 2006-07-07
1336197508 Lisa M Hassler Pediatrics 24 Newton Street, Southboro Medical Group, Southboro, MA 01772 2006-05-04
1295714640 Robin K Morgan Physical Therapist 28 Newton St, Southborough, MA 01772 2006-01-13
1528562998 Emily Marie Bagley Student in an Organized Health Care Education/Training Program 33 Turnpike Rd, Southborough, MA 01772 2018-03-21
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881614436 Paul L. Mortarelli Psychologist 24 Newton St, Southborough, MA 01772-1215 2006-07-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578162798 Psychological Transformation Psychologist 348 Cambridge Rd # 115, Woburn, MA 01801-6037 2020-10-19
1841897345 Sade Callwood Psychologist 185 Devonshire St Ste 800, Boston, MA 02110-1414 2020-10-07
1982210480 Aaron Rezendes Psyd LLC Psychologist 38 Dow St, Framingham, MA 01702-7220 2020-09-20
1184239808 Morgan Eleanor Smigielski Psychologist 65 Park Dr Apt 18, Boston, MA 02215-5238 2020-09-10
1821601568 Dr. Chelsea Levy Licensed Psychologist LLC Psychologist 203 Spring St, Medford, MA 02155-2814 2020-08-24
1679183230 Holly Muller Psychologist 225 Friend St, Boston, MA 02114-1800 2020-08-07
1285242123 Ruth Brim Balser Psychologist 36 Audubon Dr, Chestnut Hill, MA 02467-2621 2020-07-16
1952929184 Sarah Joanna Schoffstall Psychologist 32 Hastings St, Framingham, MA 01701-7954 2020-07-14
1225655871 Sasha Fleary Psychologist 28 Walter St, Hyde Park, MA 02136-2973 2020-06-30
1760008635 Katherine Renda Florek Psychologist 2 Collins Rd, Hingham, MA 02043-2017 2020-06-17
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Competitor

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City SOUTHBOROUGH
Zip Code 01772

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Dataset Information

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.

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