Provider Demographics
NPI:1477591428
Name:GRON, PAUL (EDD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:GRON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:158 COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02468-2234
Mailing Address - Country:US
Mailing Address - Phone:978-287-0101
Mailing Address - Fax:617-795-0239
Practice Address - Street 1:336 BAKER AVE
Practice Address - Street 2:SUITE 1-3
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2100
Practice Address - Country:US
Practice Address - Phone:978-287-0101
Practice Address - Fax:617-795-0239
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA3496103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWO3536OtherBCBS OF MA
MA722117OtherTUFTS HEALTH PLANS
MA010660OtherVALUE OPTIONS HEALTH PLA
MA010660OtherVALUE OPTIONS HEALTH PLA