Provider Demographics
NPI:1851988190
Name:BRUCHEZ, PAUL K, (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:K,
Last Name:BRUCHEZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BAY STATE RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-3212
Mailing Address - Country:US
Mailing Address - Phone:781-431-1313
Mailing Address - Fax:
Practice Address - Street 1:10 BAY STATE RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-3212
Practice Address - Country:US
Practice Address - Phone:781-431-1313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent