Healthcare Provider Details

I. General information

NPI: 1164843181
Provider Name (Legal Business Name): JULIA REBECCA GEFTER PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2013
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

872 MASSACHUSETTS AVE. STE. 2-2, 2-7
CAMBRIDGE MA
02139
US

IV. Provider business mailing address

1000 JEFFERSON ST. STE. 2C
LYNCHBURG VA
24504
US

V. Phone/Fax

Practice location:
  • Phone: 617-395-5806
  • Fax:
Mailing address:
  • Phone: 617-379-0496
  • Fax: 617-807-0958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number9808
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: