Healthcare Provider Details

I. General information

NPI: 1740271774
Provider Name (Legal Business Name): KATHERINE ACKERMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGS RD BLDG 6
BEDFORD MA
01730-1114
US

IV. Provider business mailing address

200 SPRINGS RD BLDG 6
BEDFORD MA
01730-1114
US

V. Phone/Fax

Practice location:
  • Phone: 781-687-3109
  • Fax: 781-687-2424
Mailing address:
  • Phone: 781-687-3109
  • Fax: 781-687-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number208114
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number208114
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: