Provider Demographics
NPI:1043412786
Name:COMMUNITY MEDICAL ALLIANCE, INC.
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL ALLIANCE, INC.
Other - Org Name:COMMUNITY MEDICAL ALLIANCE BOSTON
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERIOT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:888-897-8947
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:617-772-5519
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:617-772-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty