Mardoche Sidor, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

247199 Issued in MA

Practice address

1493 Cambridge St
Cambridge, MA 02139-1047

Phone

(617) 575-5756

NPI assigned

Jan 12, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1265737894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MAIN ST APT 57",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724312",
            "telephone_number": "718-877-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-575-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOR",
        "first_name": "MARDOCHE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "247199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah L Shulman, MD
• Anne Revelle Shumway, LICSW
• Arthur Donald Shushan, M.D.
• Ilana Sichel, PHD
• Vera Sichko-Seltzer, MS, CNM
• Cathy Siebold, DSW, LCSW
• Alan E Siegel, EDD
• Ellen Beth Siegel, PSY.D.
• Erica Siegel
• Rachel Ann Siegel

• Child & Adolescent Psychiatry Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Child & Adolescent Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.