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General NPI Number Information
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NPI Number | 1770789216
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Entity Type | Organization
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Legal Business Name | CAMBRIDGE HEALTH ALLIANCE
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1493 CAMBRIDGE ST
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City | CAMBRIDGE
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State | MA
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Zip | 02139-1047
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Country | US
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Telephone | 617-665-1187
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Fax |
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Provider Business Mailing Address
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Address Line | 41 MAGNOLIA AVE
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City | CAMBRIDGE
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State | MA
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Zip | 02138-3209
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Country | US
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Telephone | 617-455-1722
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Fax |
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Authorized Official
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Title or Position | COORDINATOR
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Name | MR. ROBERT TETRICK
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Credential | M.A.
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Telephone | 617-665-3449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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