Herzog, David Brandeis
Herzog, David Brandeis is an individual health care provider with primary practice located at 2 Longfellow Pl Suite 200, Boston MA 02114-2437. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Herzog, David Brandeis can be contacted via phone (617) 724-0799.Contact Information
Primary practice address
2 Longfellow Pl Suite 200
Boston MA 02114-2437
Phone: (617) 724-0799
Fax: (617) 726-1595
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 38347 | Massachusetts |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 38347 | Massachusetts |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 38347 | Massachusetts |
Profile Details
| NPI number | 1811978638 |
|---|---|
| LBN Legal business name | Herzog, David Brandeis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 9th, 2005 |
| Last updated | Aug 12th, 2009 - about 16 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 | 1811978638 | NPPES |
| Massachusetts | MEDICAID | 0107433 | |
| Massachusetts | Other | 700650 | |
| Massachusetts | Other | M09907 |
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