Provider Demographics
NPI:1033651104
Name:COMMUNITY MEDICAL ALLIANCE, INC
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL ALLIANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHIROSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-772-5690
Mailing Address - Street 1:253 SUMMER ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-1114
Mailing Address - Country:US
Mailing Address - Phone:888-897-8947
Mailing Address - Fax:617-526-1909
Practice Address - Street 1:253 SUMMER ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-1114
Practice Address - Country:US
Practice Address - Phone:888-897-8947
Practice Address - Fax:617-526-1909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD HEALTH PLAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2281236163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty