Provider Demographics
NPI:1144212960
Name:GERMER, CHRISTOPHER KARL (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KARL
Last Name:GERMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6535
Mailing Address - Country:US
Mailing Address - Phone:781-641-2744
Mailing Address - Fax:781-641-1903
Practice Address - Street 1:94 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-6535
Practice Address - Country:US
Practice Address - Phone:781-641-2744
Practice Address - Fax:781-641-1903
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWO3904Medicare ID - Type UnspecifiedMEDICARE B PROVIDER