Provider Demographics
NPI:1538247069
Name:FIATARONE, MARIA A (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:FIATARONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 COONANBARRA ROAD
Mailing Address - Street 2:
Mailing Address - City:WAHROONGA NSW
Mailing Address - State:AU
Mailing Address - Zip Code:2076
Mailing Address - Country:AU
Mailing Address - Phone:781-849-6476
Mailing Address - Fax:
Practice Address - Street 1:1200 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-1011
Practice Address - Country:US
Practice Address - Phone:781-849-6476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59044207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine