Most Relevant Information
Provider Data
| NPI Number: | 1003025776 |
| Provider Name: | THEODORE PETER WASIK MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2084P0800X |
| Specialty: | Psychiatry & Neurology |
| License Number: | 243789 |
Most Important Dates
| Enumeration Date: | 05/21/2007 |
| Last Updated: | 09/21/2019 |
Provider Practice Location
61 ROSELAND ST STE 8
SOMERVILLE
MA
021433536
Practice Location Phone/Fax
| Phone: | 6174701805 |
| Fax: | 6177145383 |
Provider Mailing Location
29 ALBION PL
BOSTON
MA
021291701
Provider Mailing Phone/Fax
| Phone: | 6174701805 |
| Fax: | 6177145383 |
Suggested EMR
Psychiatry EMR