Provider Demographics
NPI:1992849301
Name:TANANBAUM & ZIBBELL P.C.
Entity Type:Organization
Organization Name:TANANBAUM & ZIBBELL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TANABAUM
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:508-872-6610
Mailing Address - Street 1:1 FRANKLIN COMMONS
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6619
Mailing Address - Country:US
Mailing Address - Phone:508-872-6610
Mailing Address - Fax:508-872-6722
Practice Address - Street 1:1 FRANKLIN COMMONS
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6619
Practice Address - Country:US
Practice Address - Phone:508-872-6610
Practice Address - Fax:508-872-6722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-18
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3783103TC0700X
MA1031941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty