Provider Demographics
NPI:1790145969
Name:AUBRY, MARJORIE
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:
Last Name:AUBRY
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 1:154 OLIVE AVE EXT
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-1910
Mailing Address - Country:US
Mailing Address - Phone:617-669-8614
Mailing Address - Fax:
Practice Address - Street 1:154 OLIVE AVE EXT
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-1910
Practice Address - Country:US
Practice Address - Phone:617-669-8614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker