Basic Information
| Provider Information | |||||||||
| NPI: | 1700149309 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMONOO | ||||||||
| FirstName: | HERMIONI | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD, MPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 FENWOOD RD FL 4 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177262066 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177326727 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2012 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 261075 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.