Provider Demographics
NPI:1245253715
Name:ZITIN, BARRY (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:ZITIN
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:LAHEY CLINIC
Mailing Address - Street 2:41 MALL ROAD
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8963
Mailing Address - Fax:781-744-5235
Practice Address - Street 1:LAHEY CLINIC
Practice Address - Street 2:41 MALL ROAD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8963
Practice Address - Fax:781-744-5235
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA367942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0100030Medicaid
MA110000141AMedicaid
MAA54227Medicare UPIN
MA110000141AMedicaid