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General NPI Number Information
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NPI Number | 1336187533
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Entity Type | Individual
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Provider Name | ROBERT SEDGWICK ED. D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 48 BRIDGE ST
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City | SALEM
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State | MA
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Zip | 01970-4127
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Country | US
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Telephone | 978-740-9145
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2190
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City | WEST PEABODY
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State | MA
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Zip | 01960-7190
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Country | US
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Telephone | 781-231-7026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 6491
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License Number State | MA
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