Healthcare Provider Details

I. General information

NPI: 1619944105
Provider Name (Legal Business Name): CAMBRIDGE HEALTH ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 RAYMOND ST APT 2
CAMBRIDGE MA
02140-3315
US

IV. Provider business mailing address

156 RAYMOND STREET APT 2
CAMBRIDGE MA
02140
US

V. Phone/Fax

Practice location:
  • Phone: 617-492-1529
  • Fax:
Mailing address:
  • Phone: 617-492-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. LIOR GIVON
Title or Position: STAFF PSYCHIATRIST
Credential: M.D.
Phone: 617-665-2105