Provider Demographics
NPI:1295881449
Name:TABORS, MALAIKA (MSPT, LIC AC, M AC)
Entity type:Individual
Prefix:
First Name:MALAIKA
Middle Name:
Last Name:TABORS
Suffix:
Gender:F
Credentials:MSPT, LIC AC, M AC
Other - Prefix:
Other - First Name:MALAIKA
Other - Middle Name:
Other - Last Name:BARTHOLOMEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:186 HAMPSHIRE ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1387
Mailing Address - Country:US
Mailing Address - Phone:617-868-7000
Mailing Address - Fax:
Practice Address - Street 1:186 HAMPSHIRE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1387
Practice Address - Country:US
Practice Address - Phone:617-868-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226482171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist