Provider Demographics
NPI:1114945482
Name:HEFFERNAN, MARGARET MARY
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:HEFFERNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:407 ROUNSEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02770-2009
Mailing Address - Country:US
Mailing Address - Phone:617-667-1317
Mailing Address - Fax:617-667-7981
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:BEHAVIORAL NEUROLOGY DEPT.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-1317
Practice Address - Fax:617-667-7981
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA6704103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist