| NPI | 1245454123 |
|---|---|
| Doing Business As | MALDEN MEDICAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | MARY J DELONG Credentialing Manager 413-222-7711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2009-02-10 |