Provider Demographics
NPI:1881669265
Name:ABBOTT, ANN A (CNM)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:A
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MOUNT AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5502
Mailing Address - Country:US
Mailing Address - Phone:617-499-5151
Mailing Address - Fax:617-499-5179
Practice Address - Street 1:20 HOPE AVE
Practice Address - Street 2:STE 110
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2721
Practice Address - Country:US
Practice Address - Phone:781-893-5550
Practice Address - Fax:781-893-4965
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA197086176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0357294Medicaid
MARN0014Medicare ID - Type Unspecified
MA0357294Medicaid