Provider Demographics
NPI:1013651009
Name:CHIARAMIDA, GABRIELA
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:CHIARAMIDA
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 1:15 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3444
Mailing Address - Country:US
Mailing Address - Phone:781-864-6337
Mailing Address - Fax:
Practice Address - Street 1:820 LYNN FELLS PKWY
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-2501
Practice Address - Country:US
Practice Address - Phone:781-979-0235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-07-25
Deactivation Date:2022-04-25
Deactivation Code:
Reactivation Date:2022-05-20
Provider Licenses
StateLicense IDTaxonomies
MA18594741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice