Provider Demographics
NPI:1043255532
Name:ISBERG, ROBERTA S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:S
Last Name:ISBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1330 BEACON ST
Mailing Address - Street 2:SUITE 254
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3282
Mailing Address - Country:US
Mailing Address - Phone:617-731-3422
Mailing Address - Fax:617-731-3228
Practice Address - Street 1:1330 BEACON ST
Practice Address - Street 2:SUITE 254
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3282
Practice Address - Country:US
Practice Address - Phone:617-731-3422
Practice Address - Fax:617-731-3228
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA450372084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA727314OtherTUFTS HEALTH PLAN
MAB11695OtherBLUE CROSS BLUE SHIELD
MAB11695Medicare ID - Type Unspecified