Healthcare Provider Details
I. General information
NPI: 1821061193
Provider Name (Legal Business Name): DR PETER E YAFFE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
327D BOSTON POST RD WAYSIDE COUNSELING ASSOCIATES
SUDBURY MA
01776-3001
US
IV. Provider business mailing address
327D BOSTON POST RD WAYSIDE COUNSELING ASSOCIATES
SUDBURY MA
01776-3001
US
V. Phone/Fax
- Phone: 978-443-4262
- Fax: 978-443-4262
- Phone: 978-443-4262
- Fax: 978-443-4262
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PETER
ELLIOT
YAFFE
Title or Position: OWNER PRESIDENT
Credential: PHD
Phone: 978-443-4262