MIDDLESEX RECOVERY PROFESSIONAL CORPORATION (NPI# 1962774638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962774638 |
| Entity Type | Organization |
| Organization Name | MIDDLESEX RECOVERY PROFESSIONAL CORPORATION |
| Practice Address |
405 Pearl St Suite 4 Malden MA 02148-6644 |
| Practice Telephone | 7816050944 |
| Practice Fax Number | 7816053710 |
| Mailing Telephone | 7816050944 |
| Mailing Fax Number | 7816053710 |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |
| Authorized Official Name | DR. BRIAN WILLIAM O'CONNOR (PRESIDENT) |
| Authorized Official Telephone | 7816050944 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
72453 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
405 PEARL ST SUITE 4 |
| City | MALDEN |
| State | MA |
| Zip Code | 02148-6644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154378479 | Evan J. Zahner | Orthopaedic Surgery | 405 Pearl St, Malden, MA 02148-6644 | 2006-05-30 |
| 1487105250 | Gregory Malvey | Physician Assistant | 405 Pearl St, Malden, MA 02148-6644 | 2016-10-17 |
| 1366999351 | Emily Smalheiser | Physical Therapist | 405 Pearl St, Malden, MA 02148-6644 | 2016-09-07 |
| 1023496551 | Angela Lynn Peterson | Physical Therapist | 405 Pearl St, Malden, MA 02148-6644 | 2015-05-17 |
| 1528498664 | Adam Izzicupo | Physical Therapist | 405 Pearl St, Suite 2, Malden, MA 02148-6644 | 2013-11-26 |
| 1487089504 | Randy Widtfeldt | Physician Assistant | 405 Pearl St, Malden, MA 02148-6644 | 2013-09-09 |
| 1710278122 | Robert Hurley | Physical Therapist | 405 Pearl St, Malden, MA 02148-6644 | 2011-04-20 |
| 1417270224 | Raquel Silva Depaula | Physical Therapist | 405 Pearl St, Malden, MA 02148-6644 | 2010-03-08 |
| 1841425634 | Jessica Lynn Thomas | Physical Therapist | 405 Pearl St, Malden, MA 02148-6644 | 2009-05-21 |
| 1639366776 | North Suburban Orthopedic Associates Inc | Physical Therapist | 405 Pearl St, Malden, MA 02148-6644 | 2007-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427680743 | Cambridge Public Health Commission | Pharmacy | 350 Main Street Suite 640, Malden, MA 02148 | 2020-02-05 |
| 1568932192 | Stephanie L Octave | Behavior Technician | 28 Wolcott St, Malden, MA 02148 | 2018-11-27 |
| 1477036549 | Fabienne Odney | Registered Nurse | 41 Alpine St, Malden, MA 02148 | 2018-09-13 |
| 1972085322 | Donna Watson | Social Worker | 33 Goodwin Avenue, Malden, MA 02148 | 2018-09-02 |
| 1588144505 | Michael William Sage | Physician Assistant | Cha Malden Care Center, 195 Canal Street, Malden, MA 02148 | 2018-08-20 |
| 1255827432 | Martineau Louine | Internal Medicine | 11 Dennis Road, Malden, MA 02148 | 2018-07-10 |
| 1700378098 | Catherine Grieves | Social Worker | 785 Main St Apt. 6, Malden, MA 02148 | 2018-06-01 |
| 1215427901 | Leam Thomas | Counselor | 175 Summer Street, Apt204, Malden, MA 02148 | 2018-05-17 |
| 1629593637 | David Acuna | Counselor | 22 Plesant Street, Malden, MA 02148 | 2017-08-10 |
| 1295258580 | Judith P Phillips | Physician Assistant | 24 Auburn Street, Malden, MA 02148 | 2017-07-19 |
| Find all providers in zip 02148 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245454123 | Preventive Medicine Associates | Family Medicine | 155 Main St, Malden, MA 02148-6936 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578062758 | Robynne Brown | Family Medicine | 59 Coddington St Ste 103, Quincy, MA 02169-4510 | 2018-02-02 |
| 1528353612 | Preventive Medicine Associates | Family Medicine | 154 Lynnway, Suite 1c, Lynn, MA 01902-3479 | 2011-06-16 |
| 1659679793 | Preventive Medicine Associates | Family Medicine | 2201 Washington St, Suite 302, Roxbury, MA 02119-3212 | 2011-03-13 |
| 1568760601 | Preventive Medicine Associates | Family Medicine | 501b Washington St, Dorchester Center, MA 02124-2014 | 2011-03-13 |
| 1962705251 | Preventive Medicine Associates | Family Medicine | 9 Henshaw St, Brighton, MA 02135-2905 | 2010-12-08 |
| 1326350976 | Preventive Medicine Associates | Family Medicine | 360 Coggeshall St, New Bedford, MA 02746-1923 | 2010-07-12 |
| 1689900565 | Preventive Medicine Associates | Family Medicine | 322 Gifford St, Falmouth, MA 02540 | 2009-10-27 |
| 1962641159 | Preventive Medicine Associates | Family Medicine | 63 Winthrop St, # C1, C2, Taunton, MA 02780-6218 | 2009-02-11 |
| 1356507511 | Preventive Medicine Associates | Family Medicine | 98 Suffolk St, Holyoke, MA 01040-4458 | 2008-08-06 |
| 1194949073 | Vineyard Healthcare Assoc. | Family Medicine | 455 State Rd Ste 13, Vineyard Haven, MA 02568-5621 | 2007-04-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.