Provider Demographics
NPI:1477618593
Name:ZEIDMAN, AMOS (MD)
Entity Type:Individual
Prefix:
First Name:AMOS
Middle Name:
Last Name:ZEIDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AMOS
Other - Middle Name:
Other - Last Name:ZEIDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:657 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-2919
Mailing Address - Country:US
Mailing Address - Phone:508-872-3284
Mailing Address - Fax:508-872-3284
Practice Address - Street 1:657 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-872-3284
Practice Address - Fax:508-872-3284
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34147103T00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA703524OtherTUFTS ID
MA8244-02OtherPBH ID
MA001049OtherHARVARD ID
MA2008475OtherMASS HEALTH ID
MAB18168Medicare ID - Type Unspecified
MA2008475OtherMASS HEALTH ID