Provider Demographics
NPI:1689725350
Name:GREENMAN, DEBORAH ANNE (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:GREENMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 55
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3067
Mailing Address - Country:US
Mailing Address - Phone:617-492-2760
Mailing Address - Fax:617-497-4160
Practice Address - Street 1:875 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 55
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3067
Practice Address - Country:US
Practice Address - Phone:617-492-2760
Practice Address - Fax:617-497-4160
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA444932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB11701OtherBCBS
MAB11701Medicare ID - Type Unspecified
MAB11701OtherBCBS