Provider Demographics
NPI:1649393505
Name:MARGOLIN, ANDREW S (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:MARGOLIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LEDGEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2505
Mailing Address - Country:US
Mailing Address - Phone:508-698-9769
Mailing Address - Fax:508-698-9769
Practice Address - Street 1:132 CENTRAL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2433
Practice Address - Country:US
Practice Address - Phone:508-698-9100
Practice Address - Fax:508-698-9100
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00804103TC2200X, 103TF0000X, 103TM1800X
MA7183103TC2200X, 103TF0000X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities