Provider Demographics
NPI:1821061193
Name:DR PETER E YAFFE PC
Entity Type:Organization
Organization Name:DR PETER E YAFFE PC
Other - Org Name:WAYSIDE COUNSELING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:YAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:978-443-4262
Mailing Address - Street 1:327D BOSTON POST RD
Mailing Address - Street 2:WAYSIDE COUNSELING ASSOCIATES
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3001
Mailing Address - Country:US
Mailing Address - Phone:978-443-4262
Mailing Address - Fax:978-443-4262
Practice Address - Street 1:327D BOSTON POST RD
Practice Address - Street 2:WAYSIDE COUNSELING ASSOCIATES
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3001
Practice Address - Country:US
Practice Address - Phone:978-443-4262
Practice Address - Fax:978-443-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5619043OtherAETNA
757593OtherTUFTS HEALTH PLAN
MAW10369OtherBLUE SHIELD OF MASS
1011850OtherBEACON HEALTH STRATEGIES
MAW10369OtherBLUE SHIELD OF MASS