Provider Demographics
NPI:1447741988
Name:FEIN, ROBERT A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:FEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 MASSACHUSETTS AVE STE 197
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2808
Mailing Address - Country:US
Mailing Address - Phone:617-661-3476
Mailing Address - Fax:
Practice Address - Street 1:1770 MASSACHUSETTS AVE STE 197
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2808
Practice Address - Country:US
Practice Address - Phone:617-661-3476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1905103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic