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Individual

DR. SHERMAN EISENTHAL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
15 PARKMAN ST, WAC 8, BOSTON, MA 02114-3117
(617) 724-3132
(617) 726-7541
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
465
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0501981
MA
01
W01506
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
07/08/2007
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