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NPI Code Detail

MEDICARE: DR. AMBER N EDINOFF MD

MEDICARE: DR. AMBER N EDINOFF MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramR76606AZ
2101YM0800XMental Health Counselor
3390200000XStudent in an Organized Health Care Education/Training Program290911MA
42084P0802XAddiction Psychiatry Physician290911MA

General Provider Information

NPI Number : 1144545344
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMBER N EDINOFF MD
Provider Business Mailing Address
First Line : 115 MILL ST
Second Line :
City : BELMONT
State : MA
Zip : 02478-1048
Country : US
Telephone Number : 617-855-3802
Fax Number :
Provider Business Practice Location Address
First Line : 115 MILL ST
Second Line :
City : BELMONT
State : MA
Zip : 02478-1048
Country : US
Telephone Number : 617-855-3803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2010
Last Update Date : 11/02/2023

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