Provider Demographics
NPI:1225100241
Name:CAMBRIDGE HEALTH ALLIANCE
Entity Type:Organization
Organization Name:CAMBRIDGE HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE CLINICAL SPECIALIS
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:MALVEY
Authorized Official - Suffix:
Authorized Official - Credentials:RNCS
Authorized Official - Phone:617-591-6127
Mailing Address - Street 1:1493 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1047
Mailing Address - Country:US
Mailing Address - Phone:617-665-1216
Mailing Address - Fax:
Practice Address - Street 1:26 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-2827
Practice Address - Country:US
Practice Address - Phone:617-591-6127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA145904163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty