Dr Mark G Fanger, EDD is a
Psychologist - Clinical based in Newton Upper Falls, Massachusetts. Dr Mark G Fanger is licensed to practice in Massachusetts (license number 2215) and his current practice location is
73 Roundwood Rd, Newton Upper Falls, Massachusetts. He can be reached at his office (for appointments etc.) via phone at
(617) 969-4040.
NPI number for Dr Mark G Fanger is 1730159146 and his current mailing address is 73 Roundwood Rd, Newton, Massachusetts. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1730159146.
Healthcare Provider's Profile
| Full Name | Dr Mark G Fanger |
|---|
| Gender | Male |
|---|
| Speciality | Psychologist - Clinical |
|---|
| Location | 73 Roundwood Rd, Newton Upper Falls, Massachusetts |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1730159146
- Provider Enumeration Date: 01/26/2006
- Last Update Date: 06/29/2009
Medical Identifiers
Medical identifiers for Dr Mark G Fanger such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730159146 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | 2215 (Massachusetts) | Secondary |
| 103TA0700X | Psychologist - Adult Development & Aging | 2215 (Massachusetts) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | 2215 (Massachusetts) | Secondary |
| 103TC0700X | Psychologist - Clinical | 2215 (Massachusetts) | Primary |
| 103T00000X | Psychologist | 2215 (Massachusetts) | Secondary |
| 103TP2701X | Psychologist - Group Psychotherapy | 2215 (Massachusetts) | Secondary |
| 106H00000X | Marriage & Family Therapist | 2215 (Massachusetts) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark G Fanger is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mark G Fanger, EDD
73 Roundwood Rd,
Newton, MA 02464-1218
Ph: (617) 969-4040 | Dr Mark G Fanger, EDD
73 Roundwood Rd,
Newton Upper Falls, MA 02464-1218
Ph: (617) 969-4040 |
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