NPIMap

Organization Active NPI

Iccd Partners

  • Clinical Neuropsychologist
  • Canton, MA
National Provider Identifier
1003011388
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
ICCD PARTNERS
Practice address
340 Turnpike St
Suite 11a
Canton, MA 02021-2700
Phone
(617) 641-0900
Fax
(617) 641-0930
NPI assigned
Jun 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph Moldover, PSY.D
Title
Co Director
Phone
(617) 641-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary

Addresses

Primary practice location

340 Turnpike St
Suite 11a
Canton, MA 02021-2700

Mailing address

340 Turnpike St
Suite 11a
Canton, MA 02021-2700
Phone (617) 641-0900

Other names 1

  • Integrated Center For Child Development Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Iccd Partners7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

340 Turnpike St
Ste 1-1
Canton, MA 02021
Phone (617) 641-0900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1003011388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 TURNPIKE ST",
            "address_2": "SUITE 11A",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212700",
            "telephone_number": "617-641-0900",
            "fax_number": "617-641-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 TURNPIKE ST",
            "address_2": "SUITE 11A",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212700",
            "telephone_number": "617-641-0900",
            "fax_number": "617-641-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICCD PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "MOLDOVER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CO DIRECTOR",
        "authorized_official_telephone_number": "617-641-0900",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Center For Child Development",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.