Healthcare Provider Details

I. General information

NPI: 1841436698
Provider Name (Legal Business Name): JOSEPH JOHN TECCE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 COMMONWEALTH AVE PSYCHOLOGY DEPARTMENT
CHESTNUT HILL MA
02467-3800
US

IV. Provider business mailing address

140 COMMONWEALTH AVE PSYCHOLOGY DEPARTMENT
CHESTNUT HILL MA
02467-3800
US

V. Phone/Fax

Practice location:
  • Phone: 617-552-4121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1482
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: