Provider Demographics
NPI:1497700694
Name:ADELMAN, KENNETH JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:JAY
Last Name:ADELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:124 WATERTOWN ST STE 2D
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2500
Mailing Address - Country:US
Mailing Address - Phone:617-916-5069
Mailing Address - Fax:617-467-4073
Practice Address - Street 1:124 WATERTOWN ST STE 2D
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2500
Practice Address - Country:US
Practice Address - Phone:617-916-5069
Practice Address - Fax:617-467-4073
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1505792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry