Healthcare Provider Details

I. General information

NPI: 1366383200
Provider Name (Legal Business Name): MARIA BARBARA PAREDES MATHAY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BAMBI PAREDES MATHAY LMT

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
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
BOSTON MA
02215-5450
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-3322
  • Fax: 617-632-3988
Mailing address:
  • Phone: 617-632-3322
  • Fax: 617-632-3988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number413
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: