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NPI Code Detail

MEDICARE: DR. RICHARD S DANA ED.D.

MEDICARE: DR. RICHARD S DANA 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
1103T00000XPsychologist3230MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1W03323OTHERMABCBS

General Provider Information

NPI Number : 1568549327
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD S DANA ED.D.
Provider Business Mailing Address
First Line : 20 WALNUT ST
Second Line : SUITE 100
City : WELLESLEY HILLS
State : MA
Zip : 02481-2104
Country : US
Telephone Number : 781-235-9696
Fax Number : 781-235-9697
Provider Business Practice Location Address
First Line : 20 WALNUT ST
Second Line : SUITE 100
City : WELLESLEY HILLS
State : MA
Zip : 02481-2104
Country : US
Telephone Number : 781-235-9696
Fax Number : 781-235-9697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 10/28/2011

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