Provider Demographics
NPI:1588714919
Name:KURZWEIL, SONYA R (PHD)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:R
Last Name:KURZWEIL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1207
Mailing Address - Country:US
Mailing Address - Phone:617-332-0302
Mailing Address - Fax:
Practice Address - Street 1:203 LAKE AVE
Practice Address - Street 2:
Practice Address - City:NEWTON HIGHLANDS
Practice Address - State:MA
Practice Address - Zip Code:02461-1207
Practice Address - Country:US
Practice Address - Phone:617-332-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4491103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAKUW50722Medicare ID - Type UnspecifiedMEDICARE