Provider Demographics
NPI:1467621540
Name:ROBIN HASENFELD, PH.D., PC
Entity Type:Organization
Organization Name:ROBIN HASENFELD, PH.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-862-9346
Mailing Address - Street 1:101 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4540
Mailing Address - Country:US
Mailing Address - Phone:781-862-9346
Mailing Address - Fax:781-396-0561
Practice Address - Street 1:101 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4540
Practice Address - Country:US
Practice Address - Phone:781-862-9346
Practice Address - Fax:781-396-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4085103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty