Healthcare Provider Details

I. General information

NPI: 1144298605
Provider Name (Legal Business Name): MARGUERITE J. ABIZAID MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S MAIN ST UNIT C
MIDDLETON MA
01949-2211
US

IV. Provider business mailing address

100 S MAIN ST UNIT C
MIDDLETON MA
01949-2211
US

V. Phone/Fax

Practice location:
  • Phone: 617-838-4794
  • Fax:
Mailing address:
  • Phone: 617-838-4794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1027415
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: