1982815841 NPI number — MS. ELIZABETH BLAKE NAUGHTER MSW

Table of content: MS. ELIZABETH BLAKE NAUGHTER MSW (NPI 1982815841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982815841 NPI number — MS. ELIZABETH BLAKE NAUGHTER MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAUGHTER
Provider First Name:
ELIZABETH
Provider Middle Name:
BLAKE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982815841
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 BENJAMIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELMONT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02478-2333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-489-2709
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1493 CAMBRIDGE STREET
Provider Second Line Business Practice Location Address:
CAMBRIDGE HOSPITAL
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-665-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2007

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: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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