MEDICARE: DR. ELAINE MARY GINIEWICZ ED.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
1	103T00000X	Psychologist	6588	MA

General Provider Information

NPI Number	:	1326063355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE MARY GINIEWICZ ED.D.

Provider Business Mailing Address
First Line	:	3821 FALMOUTH RD
Second Line	:	5-D
City	:	MARSTONS MILLS
State	:	MA
Zip	:	02648-5701
Country	:	US
Telephone Number	:	508-428-6266
Fax Number	:	508-428-1007

Provider Business Practice Location Address
First Line	:	3821 FALMOUTH RD
Second Line	:	5-D
City	:	MARSTONS MILLS
State	:	MA
Zip	:	02648-5701
Country	:	US
Telephone Number	:	508-428-6266
Fax Number	:	508-428-1007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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