MEDICARE: DR. WILLIAM J GREENHOUSE PH.D.

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
1	103TC0700X	Clinical Psychologist	8140	MA

General Provider Information

NPI Number	:	1225099310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM J GREENHOUSE PH.D.

Provider Business Mailing Address
First Line	:	200 SPRINGS ROAD
Second Line	:	116-B EDITH NOURSE ROGERS MEMORIAL VA HOSPITAL
City	:	BEDFORD
State	:	MA
Zip	:	01730
Country	:	US
Telephone Number	:	781-687-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 SPRINGS RD # 116-B
Second Line	:	EDITH NOURSE ROGERS MEMORIAL VA HOSPITAL
City	:	BEDFORD
State	:	MA
Zip	:	01730-1114
Country	:	US
Telephone Number	:	781-687-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	06/03/2011

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