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NPI Code Detail

MEDICARE: ELIZABETH KAY HOPPER PH.D.

MEDICARE: ELIZABETH KAY HOPPER 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
1103TC0700XClinical Psychologist8093MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679505143
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH KAY HOPPER PH.D.
Provider Business Mailing Address
First Line : 3 FROST ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02140-1502
Country : US
Telephone Number : 617-232-1303
Fax Number : 617-232-1280
Provider Business Practice Location Address
First Line : 263 CONCORD AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-1336
Country : US
Telephone Number : 617-232-1303
Fax Number : 617-232-1280
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2007

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