Provider Demographics
NPI:1629195599
Name:PALUBECKAS, AURELIA JANINA (EDD)
Entity Type:Individual
Prefix:
First Name:AURELIA
Middle Name:JANINA
Last Name:PALUBECKAS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 600218
Mailing Address - Street 2:
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-0218
Mailing Address - Country:US
Mailing Address - Phone:617-527-5711
Mailing Address - Fax:617-527-5668
Practice Address - Street 1:93 UNION ST
Practice Address - Street 2:SUITE 409
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2244
Practice Address - Country:US
Practice Address - Phone:617-527-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY3049103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA329929OtherHARVARD-PILGRIM HEALTH CA
MA706310OtherTUFTS
MA3315-01OtherPACIFIC CARE BEHAVIORAL H
MAS004292OtherCHAMPUS
MAPY3049OtherMA LICENSE
MA61-09490OtherUNITED BEHAVIORAL HEALTH
MA0522686Medicaid
MAWO3119Medicare ID - Type Unspecified