Male or Other

Dr. Morton P. Birnbaum PH.D.

Full Name

Dr. Morton Paul Birnbaum PH.D.

NPI Number

1174604979

NPI Type

Individual Provider

Gender

Male

Enumeration Date

10/18/2006

Specialties

(Taxonomies)

Code

103TH0100X
103T00000X

Primary Taxonomy

No
No

Licenses

State

Massachusetts

License Number

402

Contact
Information

Purpose

Mailing
Location

Address

22 BREWSTER RD
410 BOSTON POST RD

City

Sudbury
Sudbury

State

MA
MA

Postal Code

01776-2408
01776-3014

Country

US
US

Telephone Number

N/A
(978) 443-0480

Identifiers

Identifier

W01579

Identifier State

MA

Identifier Issuer

BLUE CROSS/BLUE SHIELD

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address