Provider Demographics
NPI:1407057011
Name:LAWRENCE FIEMAN ED D NEUROPSYCHOLOGY
Entity Type:Organization
Organization Name:LAWRENCE FIEMAN ED D NEUROPSYCHOLOGY
Other - Org Name:FIEMAN & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:FIEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:978-745-9003
Mailing Address - Street 1:4 DOVE AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2944
Mailing Address - Country:US
Mailing Address - Phone:978-745-9003
Mailing Address - Fax:978-825-8622
Practice Address - Street 1:4 DOVE AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2944
Practice Address - Country:US
Practice Address - Phone:978-745-9003
Practice Address - Fax:978-825-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3652103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty