Provider Demographics
NPI:1689876674
Name:BAKOW, HARRY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:A
Last Name:BAKOW
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 1:35 BEDFORD ST STE 7
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4439
Mailing Address - Country:US
Mailing Address - Phone:781-862-6816
Mailing Address - Fax:
Practice Address - Street 1:35 BEDFORD ST STE 7
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4439
Practice Address - Country:US
Practice Address - Phone:781-862-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWO1941OtherBLUE CROSS BLUE SHIELD