Individual
DR. ALAN B WITKOWER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
101 MAIN ST, STE 101, MEDFORD, MA 02155-4540
(781) 391-7518
(781) 391-1030
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3000
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0511714
—
MA
Enumeration date
11/02/2005
Last updated
07/08/2007
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