Provider Demographics
NPI:1538759329
Name:STEPHANIE DAVIDOFF, M.D., PH.D., LLC
Entity type:Organization
Organization Name:STEPHANIE DAVIDOFF, M.D., PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIDOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:508-561-9495
Mailing Address - Street 1:76 WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:SHERBORN
Mailing Address - State:MA
Mailing Address - Zip Code:01770-1006
Mailing Address - Country:US
Mailing Address - Phone:508-561-9495
Mailing Address - Fax:508-653-8398
Practice Address - Street 1:23 WATER ST
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-2364
Practice Address - Country:US
Practice Address - Phone:508-561-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty