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General NPI Number Information
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NPI Number | 1649243361
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Entity Type | Individual
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Provider Name | EDGAR Y OPPENHEIMER MD
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 01/22/2018
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Provider Practice Location Address
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Address Line | 57 HIGHLAND AVE NO SHORE CHILDRENS HOSPITAL
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City | SALEM
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State | MA
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Zip | 01970-2141
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Country | US
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Telephone | 978-741-1215
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Fax | 978-740-4748
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Provider Business Mailing Address
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Address Line | PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION
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City | CHARLESTOWN
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State | MA
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Zip | 02129-9142
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Country | US
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Telephone | 617-724-0287
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Fax | 617-726-2894
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 37032
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 37032
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 261
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License Number State | NH
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