Provider Demographics
NPI:1639164460
Name:WECHSLER, JAMES STEPHEN (PHD,MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEPHEN
Last Name:WECHSLER
Suffix:
Gender:M
Credentials:PHD,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 LIBBEY INDUSTRIAL PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:EAST WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3101
Mailing Address - Country:US
Mailing Address - Phone:781-337-4224
Mailing Address - Fax:781-335-0429
Practice Address - Street 1:163 LIBBEY INDUSTRIAL PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:EAST WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3101
Practice Address - Country:US
Practice Address - Phone:781-337-4224
Practice Address - Fax:781-335-0429
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39053207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0029992OtherNEIGHBORHOOD HEALTH
MA039053OtherTUFTS HEALTH PLAN
MAC27073OtherBLUE SHIELD
MA039053OtherTUFTS MEDICARE PREFERRED
MA34451OtherBOSTON MEDICAL CENTER
MA36686OtherFALLON
MA275189OtherHARVARD PILGRIM
MA6183468Medicaid
MAA53959Medicare UPIN
MA34451OtherBOSTON MEDICAL CENTER
MAC2707301Medicare PIN