Provider Demographics
NPI:1023180437
Name:MARON, ROBERT C (EDD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:MARON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492
Mailing Address - Country:US
Mailing Address - Phone:781-449-1143
Mailing Address - Fax:781-449-5992
Practice Address - Street 1:10 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492
Practice Address - Country:US
Practice Address - Phone:781-449-1143
Practice Address - Fax:781-449-5992
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6095103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
W04958OtherBCBS
006095OtherTUFTS
085675OtherVALUE OPTIONS