Healthcare Provider Details

I. General information

NPI: 1659768513
Provider Name (Legal Business Name): AARONSON Y CHEW PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 MASSACHUSETTS AVE STE 23
CAMBRIDGE MA
02139-3070
US

IV. Provider business mailing address

875 MASSACHUSETTS AVE STE 23
CAMBRIDGE MA
02139-3070
US

V. Phone/Fax

Practice location:
  • Phone: 617-812-6868
  • Fax:
Mailing address:
  • Phone: 617-812-6868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number02021
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number28469
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number024896
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number10444
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: