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NPI Code Detail

MEDICARE: DR. HART K MACDUR PSY.D.

MEDICARE: DR. HART K MACDUR PSY.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
1103T00000XPsychologist

General Provider Information

NPI Number : 1932548120
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HART K MACDUR PSY.D.
Provider Business Mailing Address
First Line : 64 NEWBURG ST # 1
Second Line :
City : ROSLINDALE
State : MA
Zip : 02131-2809
Country : US
Telephone Number : 781-908-4712
Fax Number :
Provider Business Practice Location Address
First Line : 82 WENDELL AVE STE 100
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-7066
Country : US
Telephone Number : 781-908-4712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2013
Last Update Date : 10/04/2021

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