Provider Demographics
NPI:1669421236
Name:DAVIDOFF, STEPHANIE ALEXIS (MD PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ALEXIS
Last Name:DAVIDOFF
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
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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:508-653-8398
Mailing Address - Fax:508-655-6510
Practice Address - Street 1:27 MICA LN
Practice Address - Street 2:SUITE 205
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-1724
Practice Address - Country:US
Practice Address - Phone:781-751-1275
Practice Address - Fax:781-235-7912
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA767722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABD7553820OtherDEA NUMBER
F87994Medicare UPIN
MAJ14650Medicare ID - Type Unspecified