MEDICARE: ERIC DROGIN

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	103TF0200X	Forensic Psychologist	8040	MA

General Provider Information

NPI Number	:	1932139029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC DROGIN

Provider Business Mailing Address
First Line	:	350 LINCOLN ST
Second Line	:	SUITE 2400
City	:	HINGHAM
State	:	MA
Zip	:	02043-1578
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 LINCOLN ST
Second Line	:	SUITE 2400
City	:	HINGHAM
State	:	MA
Zip	:	02043-1578
Country	:	US
Telephone Number	:	877-877-6692
Fax Number	:	877-877-6685

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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