Individual
STEPHANIE FOSBENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(267) 374-6747
Mailing address
253 WALDEN ST UNIT 405, CAMBRIDGE, MA 02138-6742
(267) 374-6747
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
278714
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2016
Last updated
09/18/2019
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