Healthcare Provider Details

I. General information

NPI: 1689657033
Provider Name (Legal Business Name): ANNA CHRISTINA MURIEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE
BOSTON MA
02215-5450
US

IV. Provider business mailing address

450 BROOKLINE AVE # JF735
BOSTON MA
02215-5450
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-6080
  • Fax: 617-632-5567
Mailing address:
  • Phone: 617-632-6080
  • Fax: 617-632-5677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number156196
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number156196
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: