Healthcare Provider Details

I. General information

NPI: 1780214338
Provider Name (Legal Business Name): CAMBRIDGE PUBLIC HEALTH COMMISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 TOWER ST
SOMERVILLE MA
02143-1426
US

IV. Provider business mailing address

350 MAIN ST STE 31
MALDEN MA
02148-5024
US

V. Phone/Fax

Practice location:
  • Phone: 617-591-4500
  • Fax:
Mailing address:
  • Phone: 781-338-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUDY M MCCOMISKEY
Title or Position: ANALYST
Credential: DELEGATED OFFICIAL
Phone: 781-338-0242