Theodore P. Wasik, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

243789 Issued in MA

Legal business name

THEODORE P. WASIK, M.D.

Practice address

1679 Massachusetts Ave
First Floor
Cambridge, MA 02138-1877

Phone

(267) 251-0756

NPI assigned

Jul 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Theodore P. Wasik, M.D.

Title

Psychiatrist

Phone

(267) 251-0756

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1780996397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 MASSACHUSETTS AVE",
            "address_2": "FIRST FLOOR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381877",
            "telephone_number": "267-251-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 MASSACHUSETTS AVE",
            "address_2": "FIRST FLOOR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381877",
            "telephone_number": "267-251-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE P. WASIK, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "WASIK",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "267-251-0756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "243789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.