Provider Demographics
NPI:1538137310
Name:CHIARAMONTE, ANDREA C (MD MPH)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:C
Last Name:CHIARAMONTE
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 MLK JR BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1209
Mailing Address - Country:US
Mailing Address - Phone:508-757-0330
Mailing Address - Fax:508-752-9850
Practice Address - Street 1:100 MLK JR BLVD STE 4
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1209
Practice Address - Country:US
Practice Address - Phone:508-757-0330
Practice Address - Fax:508-752-9850
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159112207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G98501Medicare UPIN