Provider Demographics
NPI:1255313375
Name:ALBECK, JOSEPH HENRY (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:HENRY
Last Name:ALBECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:HENRY
Other - Last Name:ALBECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PC
Mailing Address - Street 1:PO BOX 105
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02468-0001
Mailing Address - Country:US
Mailing Address - Phone:617-484-1500
Mailing Address - Fax:617-332-0605
Practice Address - Street 1:67 LEONARD ST
Practice Address - Street 2:SUIT # 5
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2523
Practice Address - Country:US
Practice Address - Phone:617-484-1500
Practice Address - Fax:617-332-0605
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0585012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0167908Medicaid
MA058501OtherLICENSE
A55120Medicare UPIN
MA058501OtherLICENSE