Provider Demographics
NPI:1528239100
Name:BARENBOYM, ANNA (DPT)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:BARENBOYM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-1817
Mailing Address - Country:US
Mailing Address - Phone:617-889-4548
Mailing Address - Fax:617-889-9448
Practice Address - Street 1:248 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-1817
Practice Address - Country:US
Practice Address - Phone:617-889-4548
Practice Address - Fax:617-889-9448
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15871171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor