Individual
DR. DEBORAH L BLACKER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD SCD
Contact information
Practice address
55 FRUIT ST 149 2691, MASSACHUSETTS GENERAL HOSPITAL, BOSTON, MA 02114
(617) 726-5571
(617) 726-5760
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
55900
MA
2084P0805X
Geriatric Psychiatry Physician
Primary
55900
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3032663
—
MA
01
—
J08006
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/14/2006
Last updated
09/11/2025
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