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ANGELIQUE EALY MD
NPI 1184474140
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since March 25, 2024
60 FENWOOD RD, BOSTON, MA 02115(617) 732-6753 Get Directions Write a Review

NPPES record last updated: September 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Angelique Ealy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGELIQUE EALY MD (NPI 1184474140) is an individual student in an organized health care education/training program in Boston, Massachusetts, licensed in Massachusetts (3016648) and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1184474140
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameANGELIQUE EALYCredential: MD
Location Address60 FENWOOD RDBoston, MA 02115-6128
Mailing Address60 Fenwood RdBoston, MA 02115-6128
Phone(617) 732-6753
Sole ProprietorNo
Enumeration DateMarch 25, 2024
Last NPPES UpdateSeptember 8, 2025
NPPES CertifiedSeptember 8, 2025
✔ NPI 1184474140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MA · 3016648
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
60 FENWOOD RD, Boston, MA 02115
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSEPH JEFFREY TAYLOR M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-5500
DR. BENJAMIN ROCHE JOHNSTON M.D., PH.D.
Neurological Surgery
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-5500
DR. JUSTIN J FRERE MD, PHD
Student in an Organized Health Care Education/Training Program
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-6753
BRIAN LUSBY MD, MSC
Psychiatry & Neurology (Psychiatry)
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-6753
LOUISA GRACE ADAMA AJA MD
Student in an Organized Health Care Education/Training Program
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-6753
RACHAEL ROSALES
Psychiatry & Neurology (Psychiatry)
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-5056
WILLIAM FRENCH
Psychiatry & Neurology (Psychiatry)
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-5056
EMMA ELEANOR TAYLOR PENNOCK PA-C
Physician Assistant
60 FENWOOD RD
BOSTON, MA 02115
Suffolk County (617) 732-6600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angelique Ealy's NPI number?

The NPI number for Angelique Ealy is 1184474140. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Where is Angelique Ealy located?

Angelique Ealy practices at 60 Fenwood Rd, Boston, MA 02115. The listed phone number is (617) 732-6753.

What is Angelique Ealy's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Angelique Ealy was last updated on September 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.