Provider Demographics
NPI:1093922742
Name:PAUL E GREENFIELD
Entity Type:Organization
Organization Name:PAUL E GREENFIELD
Other - Org Name:NORTH SHORE PSYCHOLOGY & BEHAVIORAL MEDICINE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:978-532-7588
Mailing Address - Street 1:6 ESSEX CENTER DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960
Mailing Address - Country:US
Mailing Address - Phone:978-532-7588
Mailing Address - Fax:978-532-2494
Practice Address - Street 1:6 ESSEX CENTER DR
Practice Address - Street 2:SUITE 107
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:978-532-7588
Practice Address - Fax:978-532-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
MA3545103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM20371Medicare ID - Type UnspecifiedMENTAL HEALTH PRACTICE