Provider Demographics
NPI:1154484822
Name:ZIFF, JOEL DAVID (EDD, PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:DAVID
Last Name:ZIFF
Suffix:
Gender:M
Credentials:EDD, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 ATHELSTANE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2419
Mailing Address - Country:US
Mailing Address - Phone:617-965-3932
Mailing Address - Fax:
Practice Address - Street 1:62 ATHELSTANE RD
Practice Address - Street 2:
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-2419
Practice Address - Country:US
Practice Address - Phone:617-965-3932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2485103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02624OtherBLUE CROSS BLUE SHIELD
MAW02624OtherBLUE CROSS BLUE SHIELD