Healthcare Provider Details

I. General information

NPI: 1689617680
Provider Name (Legal Business Name): HARVEY PINSKY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MECHANIC ST
MARLBOROUGH MA
01752-4425
US

IV. Provider business mailing address

359 BERLIN RD
BOLTON MA
01740-1320
US

V. Phone/Fax

Practice location:
  • Phone: 508-366-0551
  • Fax: 978-779-2204
Mailing address:
  • Phone: 508-366-0551
  • Fax: 978-779-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY1719PR
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY1719PR
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number515
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: