Provider Demographics
NPI:1104290972
Name:MAIORANO, CHRISTINA (MED)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MAIORANO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MT AUBURN ST
Mailing Address - Street 2:304
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:401-632-8680
Mailing Address - Fax:
Practice Address - Street 1:2 MOUNT AUBURN ST
Practice Address - Street 2:304
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-6046
Practice Address - Country:US
Practice Address - Phone:401-632-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA$$$$$$$$$Medicaid