Provider Demographics
NPI:1265499792
Name:MEDINA, ANILA ZAINAB (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ANILA
Middle Name:ZAINAB
Last Name:MEDINA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:ANILA
Other - Middle Name:ZAINAB
Other - Last Name:FATIMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 CANAL ST
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527-3266
Practice Address - Country:US
Practice Address - Phone:508-865-9960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217303207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine