Healthcare Provider Details

I. General information

NPI: 1033184106
Provider Name (Legal Business Name): GERALD E ZURIFF PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 FOSTER ST
CAMBRIDGE MA
02138-4745
US

IV. Provider business mailing address

120 FOSTER ST
CAMBRIDGE MA
02138-4745
US

V. Phone/Fax

Practice location:
  • Phone: 617-868-7806
  • Fax:
Mailing address:
  • Phone: 617-868-7806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number698
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: