Provider Demographics
NPI:1902095946
Name:ROBERT L. PYLES, MD, A PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:ROBERT L. PYLES, MD, A PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:PYLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-235-6211
Mailing Address - Street 1:367 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5346
Mailing Address - Country:US
Mailing Address - Phone:781-235-6211
Mailing Address - Fax:781-235-6310
Practice Address - Street 1:367 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-5346
Practice Address - Country:US
Practice Address - Phone:781-235-6211
Practice Address - Fax:781-235-6310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28099102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty