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NPI Code Detail

MEDICARE: DR. STEVEN CHARLES HENTOFF PH.D.

MEDICARE:  DR. STEVEN CHARLES HENTOFF  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist3868MA
2103TC0700XClinical Psychologist3868MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225062235
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN CHARLES HENTOFF PH.D.
Provider Business Mailing Address
First Line : 20 MAIN ST
Second Line : SUITE 305A
City : NATICK
State : MA
Zip : 01760-4525
Country : US
Telephone Number : 508-651-3309
Fax Number : 508-651-3306
Provider Business Practice Location Address
First Line : 20 MAIN ST
Second Line : SUITE 305A
City : NATICK
State : MA
Zip : 01760-4525
Country : US
Telephone Number : 508-651-3309
Fax Number : 508-651-3306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 12/21/2010

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Directions to “ DR. STEVEN CHARLES HENTOFF PH.D.” Practice Location

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