Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 4886 | MA |
N | 103T00000X | Psychologist | 4886 | MA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | PN0853 | MA |
NPI | 1033266531 |
---|---|
Provider Name | Dr. Howard Frank Weiner |
First Address | Danvers, MA 01923-1400 |
Second Address | Danvers, MA 01923-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
W04629 | BLUE CROSS BLUE SHIELD (01) | MA |