Provider Demographics
NPI:1679609887
Name:ELIOT, ANNER B (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNER
Middle Name:B
Last Name:ELIOT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4778
Mailing Address - Country:US
Mailing Address - Phone:617-803-7505
Mailing Address - Fax:
Practice Address - Street 1:281 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4778
Practice Address - Country:US
Practice Address - Phone:617-803-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7532103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05861OtherBCBS OF MA
MAW50461Medicare ID - Type Unspecified