Provider Demographics
NPI:1649702937
Name:AMERAULT, CHRISTINA JARAMILLO (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:JARAMILLO
Last Name:AMERAULT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:19 MUZZEY ST STE 309
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5211
Mailing Address - Country:US
Mailing Address - Phone:978-795-4411
Mailing Address - Fax:978-795-4441
Practice Address - Street 1:19 MUZZEY ST STE 309
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5211
Practice Address - Country:US
Practice Address - Phone:978-795-4411
Practice Address - Fax:978-795-4441
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA271526390200000X
MA2819252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1649702937Medicaid