Individual
DR. ANTHONY J SIRACUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
167 BAILEY RD, LANESBOROUGH, MA 01237-9669
(413) 458-9601
Mailing address
167 BAILEY RD, LANESBOROUGH, MA 01237-9669
(413) 458-9601
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3480
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0518468
—
MA
Enumeration date
10/31/2005
Last updated
01/05/2021
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