1841265246 NPI number — MR. NED ANDREW WEISMAN L.I.C.S.W.

Table of content: MR. NED ANDREW WEISMAN L.I.C.S.W. (NPI 1841265246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841265246 NPI number — MR. NED ANDREW WEISMAN L.I.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEISMAN
Provider First Name:
NED
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
L.I.C.S.W.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841265246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 HUNTING RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEEDHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02494-2111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-444-6628
Provider Business Mailing Address Fax Number:
978-977-2542

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 WASHINGTON STREET
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01970-3510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-745-3130
Provider Business Practice Location Address Fax Number:
978-977-2542
Provider Enumeration Date:
02/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  104430 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008954 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 87726 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 86114 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 731634 . This is a "TUFTS HMO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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