Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Boston Plastic & Oral Surgery

Organization Clinical Neuropsychologist · NPI 1568404903

Boston Plastic & Oral Surgery is a Clinical Neuropsychologist in Boston, Massachusetts. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
7
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Practice location Address checks out

300 Longwood Ave HU-158
Boston, MA 02115-5724
Phone: (617) 355-7252
Fax: (617) 738-1657
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Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X
Clinical Neuropsychologist Taxonomy 103G00000X
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X
Pediatrics Physician Taxonomy 208000000X
Physician Assistant Taxonomy 363A00000X
Pediatric Nurse Practitioner Taxonomy 363LP0200X

Record details

NPI number1568404903
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Meara — Director · (617) 355-7252
NPI enumeratedJune 11, 2006
Last updated in NPPESJanuary 23, 2026
Certification dateJanuary 23, 2026
Mailing address300 Longwood Ave, Boston, MA 02115-5724

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