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General NPI Number Information
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NPI Number | 1386723484
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Entity Type | Individual
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Provider Name | WILLIAM R BEARDSLEE MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 300 LONGWOOD AVE
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City | BOSTON
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State | MA
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Zip | 02115-5724
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Country | US
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Telephone | 617-355-6087
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Fax | 617-730-0271
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Provider Business Mailing Address
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Address Line | 27 SHEPARD ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-1504
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Country | US
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Telephone | 617-868-9666
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34475
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 34475
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License Number State | MA
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