Basic Information
| Provider Information | |||||||||
| NPI: | 1497773493 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BINDER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 IRELAND RD | ||||||||
| Address2: | |||||||||
| City: | NEWTON CENTRE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024591268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172448389 | ||||||||
| FaxNumber: | 7814385553 | ||||||||
| Practice Location | |||||||||
| Address1: | 271 MAIN ST | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | STONEHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021803591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7814385550 | ||||||||
| FaxNumber: | 7814385553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 09/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 40877 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 6189385 | 05 | MA | MEDICAID |