Healthcare Provider Details

I. General information

NPI: 1063351658
Provider Name (Legal Business Name): JENNIFER MAUREEN PRIAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CROSSTOWN PRIMARY CARE BOSTON MEDICAL CENTER 801 MASSACHUSETTES AVE., 6TH FLOOR
BOSTON MA
02119
US

IV. Provider business mailing address

CROSSTOWN PRIMARY CARE BOSTON MEDICAL CENTER 801 MASSACHUSETTES AVE, 6TH FLOOR
BOSTON MA
02119
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-5951
  • Fax:
Mailing address:
  • Phone: 617-414-5951
  • Fax: 617-414-9251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: