Individual
MR. BENJAMIN A KUDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 927-6321
(617) 267-3667
Mailing address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 927-6321
(617) 267-3667
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
115455
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303546
—
MA
01
—
221867
MEDICARE PART A
MA
01
—
Y10138
MEDICARE, PART B
MA
Enumeration date
03/07/2008
Last updated
04/17/2012
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