Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | RN2287353 | MA |
NPI | 1003569591 |
---|---|
Provider Name | Christina Mealey |
First Address | Cambridge, MA 02141-1262 |
Second Address | Cambridge, MA 02141-1262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2022 |
Last Update Date | 03/02/2022 |