Provider Demographics
NPI:1932130598
Name:MACHT-GREENBERG, MICHAEL (PHD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MACHT-GREENBERG
Suffix:
Gender:M
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PRINCESS PINE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1228
Mailing Address - Country:US
Mailing Address - Phone:781-275-9469
Mailing Address - Fax:
Practice Address - Street 1:532 GREAT RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3415
Practice Address - Country:US
Practice Address - Phone:978-263-0439
Practice Address - Fax:978-486-3140
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6116103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist