Provider Demographics
NPI:1982793121
Name:KIRSHNER, LEWIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:A
Last Name:KIRSHNER
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 1:306 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-2211
Mailing Address - Country:US
Mailing Address - Phone:617-441-2768
Mailing Address - Fax:617-441-2791
Practice Address - Street 1:306 HARVARD ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-2211
Practice Address - Country:US
Practice Address - Phone:617-441-2768
Practice Address - Fax:617-441-2791
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA337172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA33390Medicare UPIN