Provider Demographics
NPI:1821669805
Name:NEW ENGLAND FORENSIC ASSESSMENT
Entity Type:Organization
Organization Name:NEW ENGLAND FORENSIC ASSESSMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:DUWORS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:802-876-7613
Mailing Address - Street 1:91 CAPTAIN CARLTONS RD
Mailing Address - Street 2:
Mailing Address - City:COTUIT
Mailing Address - State:MA
Mailing Address - Zip Code:02635-2706
Mailing Address - Country:US
Mailing Address - Phone:802-391-7125
Mailing Address - Fax:
Practice Address - Street 1:162 HEGEMAN AVE STE 104
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3109
Practice Address - Country:US
Practice Address - Phone:802-876-7613
Practice Address - Fax:802-876-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty