Provider Demographics
NPI:1538629738
Name:ALVERDIA HEALTH PLLC
Entity type:Organization
Organization Name:ALVERDIA HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-300-0728
Mailing Address - Street 1:125 CAMBRIDGEPARK DR STE 301
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2392
Mailing Address - Country:US
Mailing Address - Phone:617-300-0728
Mailing Address - Fax:
Practice Address - Street 1:125 CAMBRIDGEPARK DR STE 301
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2392
Practice Address - Country:US
Practice Address - Phone:617-300-0728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty