Dr. Mary K Pantuhova, PSYD
Psychologist, Clinical in Waban, Massachusetts
1497701197- Practice location
- 91 Wyman St, Waban, MA 02468-1529
- Phone
- 617-332-7596
- Fax
- 617-663-6135
- Last updated
- December 8, 2009
Mary Knorring Pantuhova is a Psychologist, Clinical based in Waban, MA. Mary Knorring Pantuhova practices in Waban, MA and has the professional credentials of PSYD. The NPI Number for Mary Knorring Pantuhova is 1497701197 and holds a License No. 6733 (MA). The current practice location address for Mary Knorring Pantuhova is 91 Wyman St, Waban, MA 02468-1529 and can be reached out via phone at 617-332-7596 and via fax at 617-663-6135.
Provider Profile Details
- NPI Number
- 1497701197
- Provider Name
- Mary Knorring Pantuhova
- Credential
- PSYD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 91 Wyman St, Waban, MA 02468-1529
- Phone Number
- 617-332-7596
- Fax Number
- 617-663-6135
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- No
- Other Names
- Dr. Mimi Pantuhova (Other Name)
- Provider Enumeration Date
- May 25, 2006
- Last Update Date
- December 8, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 91 Wyman St
Waban, MA 02468-1529 - City
- Waban
- State
- Massachusetts
- Zip
- 02468-1529
- Phone Number
- 617-332-7596
- Fax Number
- 617-663-6135
Provider Business Mailing Address Details
- Address
- 91 Wyman St
Waban, MA 02468-1529 - City
- Waban
- State
- MA
- Zip
- 02468-1529
- Phone Number
- 617-332-7596
- Fax Number
- 617-663-6135
License Information
- License Number (1)
- 6733
- License State (1)
- MA
- Taxonomy (1)
- Psychologist, Clinical · 103TC0700X · Primary
- License Number (2)
- 6733
- License State (2)
- MA
- Taxonomy (2)
- Psychologist, Clinical Child & Adolescent · 103TC2200X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Mary K Pantuhova, PSYD?
The NPI number of Dr. Mary K Pantuhova, PSYD is 1497701197. It was assigned on May 25, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Mary K Pantuhova, PSYD?
Dr. Mary K Pantuhova, PSYD is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in MA under license number 6733.
Where does Dr. Mary K Pantuhova, PSYD practice?
The practice location is 91 Wyman St, Waban, MA 02468-1529. The office can be reached at 617-332-7596 (phone) or 617-663-6135 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1497701197 directly on the NPPES registry website.