Provider Demographics
NPI:1578653804
Name:SAFRAN, ARTHUR PAUL (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:PAUL
Last Name:SAFRAN
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 1:12 IVANHOE ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2716
Mailing Address - Country:US
Mailing Address - Phone:617-969-6907
Mailing Address - Fax:617-969-7658
Practice Address - Street 1:12 IVANHOE ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2716
Practice Address - Country:US
Practice Address - Phone:617-969-6907
Practice Address - Fax:617-969-7658
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA276602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0176478Medicaid
B76620Medicare UPIN
M04625Medicare ID - Type Unspecified