MALDEN MEDICAL PRACTICE
NPI 1245454123
Family Medicine - Addiction Medicine in Malden, MA
Active since April 12, 2007
About Malden Medical Practice NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALDEN MEDICAL PRACTICE (NPI 1245454123) is a healthcare organization registered as an addiction medicine in Malden, Massachusetts and active in the NPI registry since April 2007. The organization lists Mary J Delong, Credentialing Manager, as its authorized official.
NPPES Registry Identity
NPI1245454123
Entity TypeOrganization
Primary Taxonomy207QA0401X
Legal Business NamePREVENTIVE MEDICINE ASSOCIATES
Location Address155 MAIN STMalden, MA 02148-6936
Mailing Address155 Main StMalden, MA 02148-6936 · (781) 324-1200 · Fax (781) 324-1204
Phone(781) 324-1200
Fax(781) 324-1204
Organization SubpartYes
Authorized OfficialMary J DelongCredentialing Manager · (413) 222-7711
Enumeration DateApril 12, 2007
Last NPPES UpdateFebruary 10, 2009
✔ NPI 1245454123 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
155 MAIN ST, Malden, MA 02148
Other Names 1
Doing Business AsMalden Medical Practice
Group Practice 1
Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245454123, enumerated as an "organization" on April 12, 2007.
The provider is located at 155 MAIN ST MALDEN, MA 02148 and the phone number is (781) 324-1200.
Family Medicine with taxonomy code 207QA0401X and a focus in Addiction Medicine.
