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NPI Code Detail

MEDICARE: MAX G BARANOVSKY MD

MEDICARE: MAX G BARANOVSKY 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
12084P0800XPsychiatry Physician48253MA
22084P0805XGeriatric Psychiatry Physician48253MA

General Provider Information

NPI Number : 1568455939
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAX G BARANOVSKY MD
Provider Business Mailing Address
First Line : 736 CAMBRIDGE ST
Second Line : QUINN PAVILLION 3RD FLOOR
City : BRIGHTON
State : MA
Zip : 02135-2907
Country : US
Telephone Number : 617-789-2102
Fax Number : 617-789-3477
Provider Business Practice Location Address
First Line : 736 CAMBRIDGE ST
Second Line : QUINN PAVILLION 3RD FLOOR
City : BRIGHTON
State : MA
Zip : 02135-2907
Country : US
Telephone Number : 617-789-2102
Fax Number : 617-789-3477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 09/11/2025

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Directions to “ MAX G BARANOVSKY MD” Practice Location

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