Individual
PAUL R. O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5100
Mailing address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6024
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
669495
TUFTS HEALTH PLAN
MA
01
—
W04954
BLUE CROSS
MA
Enumeration date
06/08/2006
Last updated
03/07/2021
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