| Doctor Name: | DR. KENNETH MINKOFF |
| NPI Number: | 1033103247 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 39497 |
| Business Practice Address: | 100 Powdermill Rd # 319 Acton, MA - 017205932 |
| Business Phone Number: | 9785021729 |
| Business Fax Number: | 4154558016 |
| Mailing Address: | 100 Powdermill Rd # 319, ACTON |
| State: | MA |
| Postal Code: | 017205932 |
| Phone Number: | 9785021729 |
| Fax Number: | 4154558016 |
| NPI Enumeration Date: | 09/02/2005 |
| NPI Last Update Date: | 11/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084P0802X |
| License Number: | 39497 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Psychiatry |
| Taxonomy Definition: | 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. |