Provider Demographics
NPI:1831103852
Name:EFTHIM, PAUL W (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:EFTHIM
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 1:1330 BEACON ST STE 340
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3203
Mailing Address - Country:US
Mailing Address - Phone:617-734-4644
Mailing Address - Fax:
Practice Address - Street 1:1330 BEACON ST STE 340
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3203
Practice Address - Country:US
Practice Address - Phone:617-734-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7306103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05727OtherBLUE CROSS OF MA PROVID #
MAW50275Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER