Provider Demographics
NPI:1174620884
Name:BROMFIELD, RICHARD N (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:N
Last Name:BROMFIELD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WOLCOTT RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3108
Mailing Address - Country:US
Mailing Address - Phone:617-837-2850
Mailing Address - Fax:617-879-3083
Practice Address - Street 1:5 ELM ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2859
Practice Address - Country:US
Practice Address - Phone:978-468-1740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4029103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent