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NPI Code Detail

MEDICARE: DR. RACHEL AMY TUNICK PH.D.

MEDICARE: DR. RACHEL AMY TUNICK 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
1103TC0700XClinical Psychologist8667MA

General Provider Information

NPI Number : 1295897429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL AMY TUNICK PH.D.
Provider Business Mailing Address
First Line : 100 PAUL GORE ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-1816
Country : US
Telephone Number : 617-524-8512
Fax Number :
Provider Business Practice Location Address
First Line : 300 LONGWOOD AVE
Second Line : CHILDREN'S HOSPITAL BOSTON, MAIN 8-SOUTH
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-9830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 07/08/2007

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