Wilens, Timothy Edwin

Wilens, Timothy Edwin is an individual health care provider with primary practice located at 55 Fruit St Yaw 6900, Boston MA 02114-2621. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Wilens, Timothy Edwin can be contacted via phone (617) 726-1731.

Contact Information

Primary practice address
55 Fruit St Yaw 6900 Boston MA 02114-2621
Phone: (617) 726-1731
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 57251 Massachusetts
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 57251 Massachusetts
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 57251 Massachusetts

Profile Details

NPI number 1295716074
LBN Legal business name Wilens, Timothy Edwin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Aug 13th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295716074 NPPES
Massachusetts Other 724343 TUFTS HEALTH PLAN
Massachusetts MEDICAID 3046974 TUFTS HEALTH PLAN

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