Healthcare Provider Details

I. General information

NPI: 1649325135
Provider Name (Legal Business Name): PETER K HUNT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

223 SYLVIA ST
ARLINGTON MA
02476-7008
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-6680
  • Fax:
Mailing address:
  • Phone: 781-648-5370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number6150
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: