Decter, Philip R.
Decter, Philip R. is an sole proprietor health care provider with primary practice located at 51 Kondazian St , Watertown MA 02472-2830. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Decter, Philip R. can be contacted via phone (617) 413-0447.Contact Information
Primary practice address
51 Kondazian St
Watertown MA 02472-2830
Phone: (617) 413-0447
Fax: (617) 924-5111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1031020 | Massachusetts |
Profile Details
| NPI number | 1891822169 |
|---|---|
| LBN Legal business name | Decter, Philip R. |
| Credentials | MSW, LICSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891822169 | NPPES |
| Massachusetts | MEDICAID | 1895338 |
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