Provider Demographics
NPI:1891725792
Name:NEWTON-WELLESLEY BEHAVIORAL MEDICINE & EATING DISORDERS
Entity Type:Organization
Organization Name:NEWTON-WELLESLEY BEHAVIORAL MEDICINE & EATING DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BELFER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-332-2700
Mailing Address - Street 1:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-0004
Mailing Address - Country:US
Mailing Address - Phone:617-713-2702
Mailing Address - Fax:617-277-4752
Practice Address - Street 1:1330 BEACON ST
Practice Address - Street 2:SUITE 225
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3200
Practice Address - Country:US
Practice Address - Phone:617-332-2700
Practice Address - Fax:617-277-4752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW40013Medicare ID - Type Unspecified