Basic Information
Provider Information
NPI: 1295888675
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZEIZEL
FirstName: PAUL
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1101 BEACON ST
Address2: 8 EAST
City: BROOKLINE
State: MA
PostalCode: 024465587
CountryCode: US
TelephoneNumber: 6177314300
FaxNumber: 9787506684
Practice Location
Address1: 1101 BEACON ST
Address2: 8 EAST
City: BROOKLINE
State: MA
PostalCode: 024465587
CountryCode: US
TelephoneNumber: 6177314300
FaxNumber: 9787506684
Other Information
ProviderEnumerationDate: 01/19/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X4708MAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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