Provider Demographics
NPI:1891180030
Name:MILLMAN PSYCHIATRY LLC
Entity Type:Organization
Organization Name:MILLMAN PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-566-5071
Mailing Address - Street 1:156 MASON TER
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2772
Mailing Address - Country:US
Mailing Address - Phone:617-566-5071
Mailing Address - Fax:617-566-9212
Practice Address - Street 1:156 MASON TER
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2772
Practice Address - Country:US
Practice Address - Phone:617-566-5071
Practice Address - Fax:617-566-9212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-04
Last Update Date:2015-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA819422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA081942OtherTUFTS
MAJ31912OtherBLUE CROSS BLUE SHIELD
MAA29162Medicare PIN
MAJ31912OtherBLUE CROSS BLUE SHIELD