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NPI Code Detail

MEDICARE: DR. MEREDITH M CADRA EDD, LAT, ATC, CSCS

MEDICARE: DR. MEREDITH M CADRA EDD, LAT, ATC, CSCS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer3280MA

General Provider Information

NPI Number : 1134692452
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEREDITH M CADRA EDD, LAT, ATC, CSCS
Provider Business Mailing Address
First Line : 53 MANCHESTER RD APT 4
Second Line :
City : BROOKLINE
State : MA
Zip : 02446-6072
Country : US
Telephone Number : 305-613-3534
Fax Number :
Provider Business Practice Location Address
First Line : 315 TURNPIKE ST
Second Line :
City : NORTH ANDOVER
State : MA
Zip : 01845-5800
Country : US
Telephone Number : 305-613-3534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2019
Last Update Date : 09/15/2020

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Directions to “ DR. MEREDITH M CADRA EDD, LAT, ATC, CSCS” Practice Location

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