DR. KENNETH MINKOFF (NPI# 1033103247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033103247 |
| Entity Type | Individual |
| Full Name | DR. KENNETH MINKOFF |
| Credential | MD |
| Practice Address |
100 Powdermill Rd # 319 Acton MA 01720-5932 |
| Practice Telephone | 9785021729 |
| Practice Fax Number | 4154558016 |
| Mailing Telephone | 9785021729 |
| Mailing Fax Number | 4154558016 |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2010-11-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
39497 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 2045915 | 05 |
| Street Address |
100 POWDERMILL RD # 319 |
| City | ACTON |
| State | MA |
| Zip Code | 01720-5932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346872322 | Gianpiero De Mari | Behavior Technician | 8 Post Office Square Suite 204, Acton, MA 01720 | 2020-02-07 |
| 1871134890 | Rachel Vinicor | Social Worker | 171 Pope Rd., Acton, MA 01720 | 2019-10-01 |
| 1295387991 | Manman Zhang | Nurse Practitioner | Apt B9, 9 Davis Road, Acton, MA 01720 | 2019-07-12 |
| 1215595608 | Karen Weeks | Clinical Medical Laboratory | 526 Main St, One Acton Pl, Suite 102, Acton, MA 01720 | 2019-05-31 |
| 1689165151 | Richard J. Cowen | Psychologist | 16 Charter Road, Acton, MA 01720 | 2018-05-21 |
| 1265929798 | Angela Madge | Psychologist | 525 Massachusetts Ave Ste 101g, Acton, MA 01720 | 2018-04-19 |
| 1811404544 | B-xi Operations Holding Company LLC | Assisted Living Facility | Benchmark At Robbins Brook, 10 Devon Drive, Acton, MA 01720 | 2018-01-03 |
| 1396265211 | Kristen Devenezia | Counselor | 360 Massachusetts Avenue, Suite 201, Acton, MA 01720 | 2017-06-21 |
| 1760886592 | Waybond Pllc | Clinic/Center | 31 Powder Mill Rd, Acton, MA 01720 | 2014-10-22 |
| 1760802797 | Kimberly Greene Murachver | Dietitian, Registered | 525 Massachusetts Ave Ste 101c, Acton, MA 01720 | 2014-04-17 |
| Find all providers in zip 01720 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245856335 | Mcat LLC | Psychiatry & Neurology | 3 Brighton St, Belmont, MA 02478-4007 | 2020-06-24 |
| 1427673136 | Ronald Bugaoan Md LLC | Psychiatry & Neurology | 225 Water St Ste A140, Plymouth, MA 02360-6248 | 2020-06-09 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1083894059 | Juan R Condemarin | Psychiatry & Neurology | 129 Bigelow St, Brighton, MA 02135-1639 | 2007-11-07 |
| 1548454671 | Alfredo R Chan Md PC | Psychiatry & Neurology | 105 Webster St Ste 6, Hanover, MA 02339-1227 | 2007-08-31 |
| 1669666947 | John Dmochowski, Md PC | Psychiatry & Neurology | 31 Meltiah Rd, Falmouth, MA 02540-1843 | 2007-08-30 |
| 1093876609 | Robert Long Kelley | Psychiatry & Neurology | 20 Hope Ave Suite 201, Waltham, MA 20453 | 2006-12-13 |
| 1306896527 | Ethan Samuel Rofman | Psychiatry & Neurology | 123 Grant Ave, Newton Centre, MA 02459-1350 | 2006-05-10 |
| 1497734768 | Laurence Evans Ducomb | Psychiatry & Neurology | 49 Robinwood Ave, The Arbour Hospital, Jamaica Plain, MA 02130 | 2006-01-13 |
| 1821565425 | Westborough Professional Associates, LLC | Psychiatry & Neurology | 300 Friberg Pkwy, Westborough, MA 01581-3900 | 2018-11-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.