| Doctor Name: | DR. HARVEY S WAXMAN |
| NPI Number: | 1316099757 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 1694 |
| Business Practice Address: | 29 Ashmont Rd Waban, MA - 024681202 |
| Business Phone Number: | 6172449410 |
| Business Fax Number: | 6172447484 |
| Mailing Address: | 29 Ashmont Rd, WABAN |
| State: | MA |
| Postal Code: | 024681202 |
| Phone Number: | 6172449410 |
| Fax Number: | 6172447484 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0700X |
| License Number: | 1694 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Adult Development & Aging |
| Taxonomy Definition: | |