Healthcare Provider Details

I. General information

NPI: 1447952197
Provider Name (Legal Business Name): ANNIE HEYMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MASSACHUSETTS AVE FL 4
BOSTON MA
02118-2605
US

IV. Provider business mailing address

850 HARRISON AVE FL 9
BOSTON MA
02118-4001
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-8540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1025784
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: