Provider Demographics
NPI:1861482705
Name:BOBRUFF, ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:BOBRUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 CRESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-3007
Mailing Address - Country:US
Mailing Address - Phone:617-965-1299
Mailing Address - Fax:617-965-1299
Practice Address - Street 1:1261 FURNACE BROOK PKWY
Practice Address - Street 2:SUITE 20
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4721
Practice Address - Country:US
Practice Address - Phone:617-965-1299
Practice Address - Fax:617-965-1299
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA358372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2013991Medicaid
MAB33436Medicare ID - Type Unspecified
MAA35606Medicare UPIN