Provider Demographics
NPI:1942756192
Name:PHICHALAI, PATTHRARAWALAI (MD, MPH)
Entity Type:Individual
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First Name:PATTHRARAWALAI
Middle Name:
Last Name:PHICHALAI
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:EOME 1-1402 665 HUNTINGTON AVENUE
Mailing Address - Street 2:HARVARD OCCUPATIONAL MEDICINE RESIDENCY PROGRAM
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-1677
Mailing Address - Country:US
Mailing Address - Phone:617-432-3327
Mailing Address - Fax:617-432-0219
Practice Address - Street 1:5 MIDDLESEX AVE.
Practice Address - Street 2:CAMBRIDGE HEALTH ALLIANCE, OCCUPATIONAL MEDICINE CLINIC
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-1677
Practice Address - Country:US
Practice Address - Phone:617-591-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-09-22
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Provider Licenses
StateLicense IDTaxonomies
MA2653202083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine