Unknown Individual – Psychiatry Physician, NPI 1659394732

Unknown Individual is a healthcare provider. based in Newton lower falls, Massachusetts. specializing in Psychiatry Physician. They hold a License No. 30940 (MA). The NPI Number for Unknown Individual is 1659394732

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1659394732
Phone
(617) 243-6450
Address
2000 WASHINGTON STREET
Deactivation Date
9 December 2021

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Secondary Phone
6172436450
Graduation Year
1964 (62 years ago)
PAC ID
9537216726
Professional Enrollment ID
I20090403000277
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2000, Washington Street, Newton Lower Falls, West Newton, Newton, Middlesex County, Massachusetts, 02481, United States

    SUITE 302 MOBI BLUE BUILDING

    NEWTON LOWER FALLS, MA 024621602

    Phone: (617) 243-6450

    Type: Location

  • 542, Chestnut Street, Waban, West Newton, Newton, Middlesex County, Massachusetts, 02468, United States

    WABAN, MA 024681207

    Phone: (617) 332-0466

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02462)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1659394732 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Newton Lower Falls, Massachusetts.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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