1740395540 NPI number — CECILIA A TIGHE CRNA

Table of content: CECILIA A TIGHE CRNA (NPI 1740395540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740395540 NPI number — CECILIA A TIGHE CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TIGHE
Provider First Name:
CECILIA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
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:
1740395540
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:
PHYSICIANS ACCOUNTS RECEIVABLE
Provider Second Line Business Mailing Address:
PO BOX 414628
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-4628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-449-6150
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2014 WASHINGTON ST
Provider Second Line Business Practice Location Address:
NEWTON WELLESLEY HOSPITAL DEPT OF ANESTHESIA
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02462-1607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-243-6298
Provider Business Practice Location Address Fax Number:
617-243-6184
Provider Enumeration Date:
08/20/2006

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: 367500000X , with the licence number:  106662 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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