Provider Demographics
NPI:1821026642
Name:LITWIN, PETER MICHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:MICHAEL
Last Name:LITWIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:45 POWOW ST
Mailing Address - Street 2:12 MARKET SQ
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-1624
Mailing Address - Country:US
Mailing Address - Phone:978-388-0799
Mailing Address - Fax:978-388-1377
Practice Address - Street 1:12 MARKET SQ
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2442
Practice Address - Country:US
Practice Address - Phone:978-388-0799
Practice Address - Fax:978-388-1377
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8478103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAL1W51454Medicare ID - Type Unspecified