Provider Demographics
NPI:1942835830
Name:FIEDLER, MALERIE
Entity Type:Individual
Prefix:
First Name:MALERIE
Middle Name:
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MALERIE
Other - Middle Name:
Other - Last Name:DOOLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1249 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3417
Mailing Address - Country:US
Mailing Address - Phone:617-264-3000
Mailing Address - Fax:
Practice Address - Street 1:1249 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3417
Practice Address - Country:US
Practice Address - Phone:617-264-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2353871835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care