Randy Lyanne Gollub MD PHD

NPI 1003807710 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1003807710
Gender Female
Enumeration Date 11/02/2005
Last Updated 08/30/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
185 CAMBRIDGE ST, 2ND FLOOR
SIMCHES RESEARCH CENTER
BOSTON MA, 02114, US
Phone (617) 724-9602
Fax (617) 726-4078
Business Location
PO BOX 9142
MASS GENERAL PHYSICIAN ORGANIZATION
CHARLESTOWN MA, 02129-9142, US
Phone (617) 724-9602
Fax (617) 726-4078
Toxanomy
Taxonomy Code 2084P0800X
License State Massachusetts
License Number 77720
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According to our database, Dr. Randy Lyanne Gollub MD PHD NPI is 1003807710, taxonomy code is 2084P0800X and license number is 77720, license state is located at Massachusetts. Randy Lyanne Gollub MD PHD physically located at 185 Cambridge St, 2nd Floor, Boston MA, 02114. NPI Number Randy Lyanne Gollub MD PHD has the Individual type.

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1003807710 NPI number is provided on an as is basis without warranty of any kind. 1003807710 is maintained by the National Plan & Provider Enumeration System. The contents of Randy Lyanne Gollub MD PHD are for informational purposes only.