Provider Demographics
NPI:1659328433
Name:KINSBOURNE, MARCEL (MD)
Entity Type:Individual
Prefix:
First Name:MARCEL
Middle Name:
Last Name:KINSBOURNE
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 1:158 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2414
Mailing Address - Country:US
Mailing Address - Phone:781-729-8201
Mailing Address - Fax:
Practice Address - Street 1:158 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2414
Practice Address - Country:US
Practice Address - Phone:781-729-8201
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA469942080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics