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General NPI Number Information
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NPI Number | 1114885407
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Entity Type | Individual
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Provider Name | CYNTHIA P MALETTE
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Gender | Female
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 201 RIVER ST
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City | MATTAPAN
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State | MA
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Zip | 02126-2713
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Country | US
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Telephone | 617-534-9169
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Fax | 857-288-6670
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Provider Business Mailing Address
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Address Line | 1010 MASS AVE
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City | BOSTON
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State | MA
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Zip | 02118-2600
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Country | US
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Telephone | 617-534-9169
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Fax | 857-288-6670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | MA
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