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Individual

DR. WILLIAM IRA BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
49 HANCOCK ST, 204, CAMBRIDGE, MA 02139-3188
(617) 576-6199
(617) 628-1617
Mailing address
21 LEXINGTON AVE, 2, SOMERVILLE, MA 02144-2608
(617) 666-7707
(617) 628-1617

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
73876
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3124151
MA
Enumeration date
03/25/2006
Last updated
07/19/2011
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