Individual
DR. ISIDORE LAWRENCE BERENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
88 E NEWTON ST # B410, BOSTON, MA 02118-2308
(617) 638-8674
(617) 638-8724
Mailing address
88 E NEWTON ST # B410, BOSTON, MA 02118-2308
(617) 638-8674
(617) 638-8724
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
39577
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110957
—
MA
01
—
161253000
MAGELLAN BEHAVIORAL HEALT
MA
01
—
759194
TUFTS
MA
Enumeration date
07/15/2006
Last updated
08/20/2012
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