Provider Demographics
NPI:1922168889
Name:KERZNER, ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:
Last Name:KERZNER
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 1:16 KINGS WAY UNIT 101B
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-9006
Mailing Address - Country:US
Mailing Address - Phone:781-890-0720
Mailing Address - Fax:
Practice Address - Street 1:26 TRAPELO RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-4457
Practice Address - Country:US
Practice Address - Phone:617-484-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB47110OtherBLUE CROSS BLUE SHIELD