Provider Demographics
NPI:1003825415
Name:CHEIFETZ, MARCY A (MD)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:A
Last Name:CHEIFETZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:291 INDEPENDENCE DR FL 9
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3628
Mailing Address - Country:US
Mailing Address - Phone:617-541-6675
Mailing Address - Fax:617-541-7505
Practice Address - Street 1:291 INDEPENDENCE DR FL 9
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3628
Practice Address - Country:US
Practice Address - Phone:617-541-6675
Practice Address - Fax:617-541-7505
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA220958207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2655132OtherCIGNA
MA469505OtherTUFTS HEALTH PLAN
MA0033087OtherNEIGHBORHOOD HEALTH PLAN
MAJ27529OtherBLUE CROSS
MAAA13085OtherHARVARD PILGRIM
MA2089891Medicaid
MAH58497Medicare UPIN
MA2089891Medicaid