Organization
JERRY WACKS, MD
Active
Organization
JERRY WACKS, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY WACKS (OWNER)
(781) 861-6767
Entity
Organization
Contact information
Practice address
35 BEDFORD ST, SUITE 1, LEXINGTON, MA 02420-4320
(781) 862-6767
(781) 861-6953
Mailing address
35 BEDFORD ST, SUITE 1, LEXINGTON, MA 02420-4320
(781) 862-6767
(781) 861-6953
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3999
MA
1041C0700X
Clinical Social Worker
1023844
MA
1041C0700X
Clinical Social Worker
110987
MA
2084P0800X
Psychiatry Physician
Primary
28783
MA
Other
Enumeration date
08/09/2007
Last updated
08/14/2007
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