Provider Demographics
NPI:1689727745
Name:RANIERE, DAVID FRANCIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FRANCIS
Last Name:RANIERE
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 1:1679 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1807
Mailing Address - Country:US
Mailing Address - Phone:617-441-9222
Mailing Address - Fax:
Practice Address - Street 1:1679 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1807
Practice Address - Country:US
Practice Address - Phone:617-441-9222
Practice Address - Fax:617-441-3533
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7853103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06034OtherBCBS OF MA PROVIDER #