Provider Demographics
NPI:1679623698
Name:SCHWEITZER, THOMAS M (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:SCHWEITZER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12 ARROW ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5105
Mailing Address - Country:US
Mailing Address - Phone:617-876-0309
Mailing Address - Fax:617-876-1696
Practice Address - Street 1:12 ARROW ST
Practice Address - Street 2:SUITE 210
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5105
Practice Address - Country:US
Practice Address - Phone:617-876-0309
Practice Address - Fax:617-876-1696
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA3073103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03160Medicare ID - Type UnspecifiedPSYCHOLOGIST