| Dr Sean Glass, MD | |
| 
					55 Fruit St, Warren 605, Boston, MA 02114-2621  | |
| (617) 726-5758 | |
| Not Available | 
| Full Name | Dr Sean Glass | 
|---|---|
| Gender | Male | 
| Speciality | Psychiatry & Neurology - Psychiatry | 
| Location | 55 Fruit St, Boston, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1083938955 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 258687 (Massachusetts) | Secondary | 
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD186505 (Oregon) | Primary | 
| Entity Name | Legacy Clinics Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1902827272 PECOS PAC ID: 0244144004 Enrollment ID: O20031117000089  | 
| Entity Name | Silverton Health | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1669424354 PECOS PAC ID: 8921901877 Enrollment ID: O20040129000172  | 
| Entity Name | Kaiser Foundation Health Plan Of The Northwest | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040130000799  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Sean Glass, MD 55 Fruit St, Boston, MA 02114-2621 Ph: () -  | Dr Sean Glass, MD 55 Fruit St, Warren 605, Boston, MA 02114-2621 Ph: (617) 726-5758  | 
Dr. Lee Edwin Goldstein, M.D., PH.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 670 Albany St, Boston, MA 02118 Phone: 617-414-8361 Fax: 617-414-7073  | |
Dr. Joseph Yeretsian, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 361 Newbury St Fl 5, Boston, MA 02115 Phone: 617-865-4910 Fax: 617-507-1426  | |
Dr. Michael Gulliver Erkkinen, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 75 Francis St, Boston, MA 02115 Phone: 617-732-5500  | |
Dr. Joseph Jeffrey Taylor, M.D., PH.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 60 Fenwood Rd, Boston, MA 02115 Phone: 617-732-5500  | |
Sanjay Menon, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 55 Fruit St., Massachusetts General Hospital, Boston, MA 02114 Phone: 857-238-5600  | |
Fatemeh Mohammadpour Touserkani,  Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000  | |
Lara Basovic, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 55 Fruit St, Boston, MA 02114 Phone: 617-726-3311  |