Provider Demographics
NPI:1467490318
Name:HOLZMAN, TODD F (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:F
Last Name:HOLZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 MOUNT AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5607
Mailing Address - Country:US
Mailing Address - Phone:617-491-4333
Mailing Address - Fax:
Practice Address - Street 1:249 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5607
Practice Address - Country:US
Practice Address - Phone:617-491-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM08120OtherBLUE CROSS
MA0017379OtherNEIGHBORHOOD HEALTH PLAN
MA711291OtherTUFTS HEALTH PLAN
MAA66031Medicare UPIN
MA711291OtherTUFTS HEALTH PLAN