Healthcare Provider Details

I. General information

NPI: 1174729180
Provider Name (Legal Business Name): CLAUDIA MAGDANZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAUDIA MILLINA

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 CAMBRIDGE STREET CAMBRIDGE HEALTH ALLIANCE
CAMBRIDGE MA
02139
US

IV. Provider business mailing address

1493 CAMBRIDGE ST CAMBRIDGE HEALTH ALLIANCE MEDICAL SPECIALTIES
CAMBRIDGE MA
02139
US

V. Phone/Fax

Practice location:
  • Phone: 617-665-1552
  • Fax: 617-665-1925
Mailing address:
  • Phone: 617-665-1552
  • Fax: 617-665-1925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number234640
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: