Healthcare Provider Details

I. General information

NPI: 1265368484
Provider Name (Legal Business Name): EAST ASTRA PARTNERS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 KINNAIRD ST
CAMBRIDGE MA
02139-3733
US

IV. Provider business mailing address

955 MASSACHUSETTS AVE STE 158
CAMBRIDGE MA
02139-3180
US

V. Phone/Fax

Practice location:
  • Phone: 857-321-9357
  • Fax:
Mailing address:
  • Phone: 332-699-6778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH GORDON
Title or Position: ADMINISTRATOR
Credential:
Phone: 617-921-1458