Healthcare Provider Details

I. General information

NPI: 1740271436
Provider Name (Legal Business Name): JEFFREY B SHEER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAIN ST SUITE 607
CHARLESTOWN MA
02129-1125
US

IV. Provider business mailing address

529 MAIN ST SUITE 607
CHARLESTOWN MA
02129-1125
US

V. Phone/Fax

Practice location:
  • Phone: 781-874-9109
  • Fax: 888-490-0703
Mailing address:
  • Phone: 781-874-9109
  • Fax: 888-490-0703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number8272
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8272
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: