Provider Demographics
NPI:1225261589
Name:CAMBRIDGE HEALTH ALLIANCE
Entity Type:Organization
Organization Name:CAMBRIDGE HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACCUMASCAIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-665-1185
Mailing Address - Street 1:153 LEYDEN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-2617
Mailing Address - Country:US
Mailing Address - Phone:617-974-1185
Mailing Address - Fax:
Practice Address - Street 1:153 LEYDEN ST APT 2
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2617
Practice Address - Country:US
Practice Address - Phone:617-974-1185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PLEASE USE N/A273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit