Provider Demographics
NPI:1861709180
Name:HIRSHBERG, ALEX (MA)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:HIRSHBERG
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1972
Mailing Address - Country:US
Mailing Address - Phone:617-224-7533
Mailing Address - Fax:
Practice Address - Street 1:72 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-1972
Practice Address - Country:US
Practice Address - Phone:617-224-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health