Healthcare Provider Details

I. General information

NPI: 1760446223
Provider Name (Legal Business Name): DAVID AVRAM ADLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TUFTS-NEW ENGLAND MEDICAL CENTER, 750 WASHINGTON ST. #1007
BOSTON MA
02111
US

IV. Provider business mailing address

20 SYLVAN AVE
NEWTON MA
02465-3016
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-8755
  • Fax: 617-636-8351
Mailing address:
  • Phone: 617-636-8755
  • Fax: 617-636-8351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number36745
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: