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DR. KENNETH MINKOFF MD NPI 1033103247


NPI Information

NPI: 1033103247
Provider Name: DR. KENNETH MINKOFF, MD
Classification: Psychiatry & Neurology - 2084P0802X
Entity Type: Individual

Specialization: Addiction Psychiatry

PECOS Registration: Yes

Address:
100 POWDERMILL RD # 319
ACTON, MA
ZIP 01720
Phone: (978) 502-1729
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DR. Kenneth Minkoff, MD is an addiction psychiatry psychiatry neurology in Acton, MA with 51 years of experience. The provider is 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. DR. Kenneth Minkoff, MD NPI is 1033103247. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Graduation Year:1973

The provider's business location address is:

100 POWDERMILL RD # 319
ACTON, MA
ZIP 01720-932
Phone: (978) 502-1729
Fax: (415) 455-8016

The NPI 1033103247 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/2/2005 and was last updated on 11/29/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0802XPsychiatry & NeurologyAddiction Psychiatry39497MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B39155MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
22045915MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.