Wilens, Timothy Edwin
Wilens, Timothy Edwin is an individual health care provider with primary practice located at 55 Fruit St Yaw 6900, Boston MA 02114-2621. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Wilens, Timothy Edwin can be contacted via phone (617) 726-1731.Contact Information
Primary practice address
55 Fruit St Yaw 6900
Boston MA 02114-2621
Phone: (617) 726-1731
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 57251 | Massachusetts |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 57251 | Massachusetts |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 57251 | Massachusetts |
Profile Details
| NPI number | 1295716074 |
|---|---|
| LBN Legal business name | Wilens, Timothy Edwin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 9th, 2005 |
| Last updated | Aug 13th, 2012 - about 12 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 | 1295716074 | NPPES |
| Massachusetts | Other | 724343 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 3046974 | TUFTS HEALTH PLAN |
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