Healthcare Provider Details

I. General information

NPI: 1285670471
Provider Name (Legal Business Name): MERRIMACK PSYCHIATRIC ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MERRIMACK VALLEY HOSPITAL, ABU 140 LINCOLN AVE
HAVERHILL MA
01830
US

IV. Provider business mailing address

11 SAMANTHA WAY
ACTON MA
01720-4173
US

V. Phone/Fax

Practice location:
  • Phone: 978-521-8339
  • Fax:
Mailing address:
  • Phone: 978-264-9423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number216574
License Number StateMA

VIII. Authorized Official

Name: PING CUI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 978-521-8810