Provider Demographics
NPI:1184025900
Name:CAMBRIDGE HEALTH ALLIANCE
Entity Type:Organization
Organization Name:CAMBRIDGE HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESEARCH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:REATEGUI-SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:617-875-2218
Mailing Address - Street 1:79 ANDREWS ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-1226
Mailing Address - Country:US
Mailing Address - Phone:617-875-2218
Mailing Address - Fax:
Practice Address - Street 1:79 ANDREWS ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-1226
Practice Address - Country:US
Practice Address - Phone:617-875-2218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health