Healthcare Provider Details

I. General information

NPI: 1598811085
Provider Name (Legal Business Name): LOREN CATRAMBONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 VICTORY RD
QUINCY MA
02171-3139
US

IV. Provider business mailing address

69 MOFFAT RD
QUINCY MA
02169-2538
US

V. Phone/Fax

Practice location:
  • Phone: 617-774-1040
  • Fax:
Mailing address:
  • Phone: 617-479-1832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: