Provider Demographics
NPI:1265422638
Name:SPERLING, REISA A (MD)
Entity type:Individual
Prefix:DR
First Name:REISA
Middle Name:A
Last Name:SPERLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:111 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6002
Mailing Address - Country:US
Mailing Address - Phone:857-307-0896
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BRIGHAM & WOMEN'S HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-8060
Practice Address - Fax:617-264-5212
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA817072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA081707OtherTUFTS HEALTH PLAN
MA3154688Medicaid
MAJ16763OtherBCBS MA
G64150Medicare UPIN
MA3154688Medicaid