Most Relevant Information
Provider Data
| NPI Number: | 1003315730 |
| Provider Name: | ETHAN ZACHARY STEIN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/08/2018 |
| Last Updated: | 02/08/2018 |
Provider Practice Location
460 QUINCY AVE
QUINCY
MA
021698130
Practice Location Phone/Fax
| Phone: | 9783879023 |
| Fax: |
Provider Mailing Location
460 QUINCY AVE
QUINCY
MA
021698130
Provider Mailing Phone/Fax
| Phone: | 6178471950 |
| Fax: | 6177741490 |