| Stephen Rothenberg,psy.d.,p.c. | |
|
10 Newbury St # 4 Boston MA 02116-3204 | |
| (617) 274-8734 | |
| Not Available |
| Full Name | Stephen Rothenberg,psy.d.,p.c. |
|---|---|
| Speciality | Psychologist |
| Location | 10 Newbury St # 4, Boston, Massachusetts |
| Authorized Official Name and Position | Stephen Rothenberg (PRESIDENT) |
| Authorized Official Contact | 6172748734 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen Rothenberg,psy.d.,p.c. Po Box 170809 Boston MA 02117-1039 Ph: (617) 274-8734 | Stephen Rothenberg,psy.d.,p.c. 10 Newbury St # 4 Boston MA 02116-3204 Ph: (617) 274-8734 |
| NPI Number | 1750589453 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 10/26/2023 |
| Certification Date | 10/26/2023 |
| Medicare PECOS PAC ID | 2567861461 |
|---|---|
| Medicare Enrollment ID | O20210526000982 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750589453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3229 (Massachusetts) | Primary |
| Provider Name | Stephen Rothenberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356443352 PECOS PAC ID: 2961571682 Enrollment ID: I20080521000590 |
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