Active NPI
Paul L. Mortarelli, PH.D.
- Psychologist
- Southborough, MA
National Provider Identifier
1881614436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6308
- Practice address
- 24 Newton St
Southborough, MA 01772-1215 - Phone
- (508) 460-3190
- Fax
- (508) 460-3297
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6308 | MA | Primary |
Addresses
Primary practice location
24 Newton St
Southborough, MA 01772-1215
Mailing address
24 Newton St
Southborough, MA 01772-1215
Phone (508) 460-3190
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 |
|---|---|---|---|
| 6308 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1881614436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 NEWTON ST",
"city": "SOUTHBOROUGH",
"state": "MA",
"postal_code": "017721215",
"telephone_number": "508-460-3190",
"fax_number": "508-460-3297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 NEWTON ST",
"city": "SOUTHBOROUGH",
"state": "MA",
"postal_code": "017721215",
"telephone_number": "508-460-3190",
"fax_number": "508-460-3297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTARELLI",
"first_name": "PAUL",
"middle_name": "L.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.