Active NPI
Harvey Dulberg, PHD
- Exercise & Sports Psychologist
- Brookline, MA
National Provider Identifier
1821182015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exercise & Sports Psychologist
- License
- 2819
- Practice address
- 1330 Beacon St
Suite 248
Brookline, MA 02446-3282 - Phone
- (617) 232-5200
- Fax
- (617) 713-3934
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exercise & Sports Psychologist | 103TE1100X | 2819 | MA | Primary |
Addresses
Primary practice location
1330 Beacon St
Suite 248
Brookline, MA 02446-3282
Mailing address
1330 Beacon St
Suite 248
Brookline, MA 02446-3282
Phone (617) 232-5200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 722394 | Other | MA | TUFT |
| W02989 | Other | MA | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2819 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821182015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 BEACON ST",
"address_2": "SUITE 248",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463282",
"telephone_number": "617-232-5200",
"fax_number": "617-713-3934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 BEACON ST",
"address_2": "SUITE 248",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463282",
"telephone_number": "617-232-5200",
"fax_number": "617-713-3934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DULBERG",
"first_name": "HARVEY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TE1100X",
"taxonomy_group": "",
"desc": "Psychologist, Exercise & Sports",
"state": "MA",
"license": "2819",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFT",
"identifier": "722394",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "W02989",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.