Provider Demographics
NPI:1295903946
Name:NORMAN A NEIBERG PHD PC
Entity type:Organization
Organization Name:NORMAN A NEIBERG PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:NEIBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-969-9329
Mailing Address - Street 1:72 DALTON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1937
Mailing Address - Country:US
Mailing Address - Phone:617-969-9329
Mailing Address - Fax:
Practice Address - Street 1:72 DALTON RD
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-1937
Practice Address - Country:US
Practice Address - Phone:617-969-9329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA301103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W10057OtherBCBSMA