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Individual

R TRACY MACNAB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2500 MASSACHUSETTS AVE, CAMBRIDGE, MA 02140-1628
(617) 661-6225
Mailing address
2500 MASSACHUSETTS AVE, CAMBRIDGE, MA 02140-1628
(617) 661-6225

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3913
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04340308502
PACIFICARE
MA
01
268251
MAGELLAN
MA
01
5302059
AETNA
MA
01
6191107
UNITED HEALTH CARE
MA
01
733061
TUFTS HEALTH PLAN
MA
01
W03857
BCBS OF MA
MA
Enumeration date
12/27/2006
Last updated
07/08/2007
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