Provider Demographics
NPI:1952322364
Name:DESSAIN, ERIC CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CHARLES
Last Name:DESSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:62 CONANT RD
Mailing Address - Street 2:GARAGE ENTRANCE
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3913
Mailing Address - Country:US
Mailing Address - Phone:781-259-3332
Mailing Address - Fax:781-259-1502
Practice Address - Street 1:62 CONANT RD
Practice Address - Street 2:GARAGE ENTRANCE
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3913
Practice Address - Country:US
Practice Address - Phone:781-259-3332
Practice Address - Fax:781-259-1502
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2014-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA482882084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF99986Medicare UPIN