Provider Demographics
NPI:1285670471
Name:MERRIMACK PSYCHIATRIC ASSOCIATES, PC
Entity Type:Organization
Organization Name:MERRIMACK PSYCHIATRIC ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PING
Authorized Official - Middle Name:
Authorized Official - Last Name:CUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-521-8810
Mailing Address - Street 1:11 SAMANTHA WAY
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4173
Mailing Address - Country:US
Mailing Address - Phone:978-264-9423
Mailing Address - Fax:
Practice Address - Street 1:MERRIMACK VALLEY HOSPITAL, ABU
Practice Address - Street 2:140 LINCOLN AVE
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-521-8339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2165742084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18329OtherBC BS OF MA
MAM18329OtherBC BS OF MA