Provider Demographics
NPI:1073592101
Name:METZGER, ERAN DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ERAN
Middle Name:DANIEL
Last Name:METZGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:59 GRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4701
Mailing Address - Country:US
Mailing Address - Phone:617-363-8481
Mailing Address - Fax:617-363-8929
Practice Address - Street 1:1200 CENTRE ST
Practice Address - Street 2:HEBREW REHABILITATION CENTER
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-1011
Practice Address - Country:US
Practice Address - Phone:617-363-8481
Practice Address - Fax:617-363-8929
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA601152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3081001Medicaid
MAJ11118Medicare ID - Type Unspecified
MAE84983Medicare UPIN