Provider Demographics
NPI:1689694564
Name:GELFAND, ELIZABETH B (EDD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:B
Last Name:GELFAND
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 1:9 DAMONMILL SQ
Mailing Address - Street 2:SUITE 3-1A
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2858
Mailing Address - Country:US
Mailing Address - Phone:978-287-0008
Mailing Address - Fax:978-456-6823
Practice Address - Street 1:9 DAMONMILL SQ
Practice Address - Street 2:SUITE 3-1A
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2858
Practice Address - Country:US
Practice Address - Phone:978-287-0008
Practice Address - Fax:978-456-6823
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4079103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04059Medicare ID - Type Unspecified