1326038928 NPI number — DR. MARCY GLEIT CARTY MD, MPH

Table of content: DR. MARCY GLEIT CARTY MD, MPH (NPI 1326038928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326038928 NPI number — DR. MARCY GLEIT CARTY MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTY
Provider First Name:
MARCY
Provider Middle Name:
GLEIT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GLEIT
Provider Other First Name:
MARCY
Provider Other Middle Name:
ALEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326038928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
31A IROQUOIS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROXBURY CROSSING
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02120-2810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-734-7278
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 FRANCIS ST
Provider Second Line Business Practice Location Address:
HOSPITALIST OFFICE; BB430
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115-6110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-732-5513
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/25/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  297314 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 62293 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 223416 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)