Provider Demographics
NPI:1902845902
Name:MANEGOLD, DEBORAH K (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:MANEGOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-4113
Mailing Address - Country:US
Mailing Address - Phone:781-259-8908
Mailing Address - Fax:
Practice Address - Street 1:1842 BEACON ST STE 402
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-1922
Practice Address - Country:US
Practice Address - Phone:781-690-1317
Practice Address - Fax:617-353-5614
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2098892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry