Provider Demographics
NPI:1346326212
Name:POST-MELCHISKEY, MARCIA EMILY
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:EMILY
Last Name:POST-MELCHISKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1103
Mailing Address - Country:US
Mailing Address - Phone:857-928-6500
Mailing Address - Fax:
Practice Address - Street 1:2464 MASS AVE
Practice Address - Street 2:SUITE #312A
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1646
Practice Address - Country:US
Practice Address - Phone:857-928-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10277421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4743-01OtherPBH ID#
MAP08107OtherBCBSMA PROVIDER NUMBER
MAP20583Medicare ID - Type UnspecifiedPROVIDER ID #