Provider Demographics
NPI:1760446223
Name:ADLER, DAVID AVRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AVRAM
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-3016
Mailing Address - Country:US
Mailing Address - Phone:617-636-8755
Mailing Address - Fax:617-636-8351
Practice Address - Street 1:TUFTS-NEW ENGLAND MEDICAL CENTER, 750 WASHINGTON ST.
Practice Address - Street 2:#1007
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-8755
Practice Address - Fax:617-636-8351
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2010-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA367452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0134163Medicaid
MAM09099Medicare ID - Type Unspecified
MA0134163Medicaid