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NPI Code Detail

MEDICARE: MARISSA CAAN MD

MEDICARE: MARISSA CAAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician00000000000000000000MA
22084P0800XPsychiatry Physician298070MA

General Provider Information

NPI Number : 1093219669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA CAAN MD
Provider Business Mailing Address
First Line : 1493 CAMBRIDGE ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02139-1047
Country : US
Telephone Number : 617-655-1000
Fax Number :
Provider Business Practice Location Address
First Line : 1493 CAMBRIDGE ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02139-1099
Country : US
Telephone Number : 617-655-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2018
Last Update Date : 02/09/2026

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Directions to “ MARISSA CAAN MD” Practice Location

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