Provider Demographics
NPI:1225363674
Name:CHEVRY, GEORGIANA (MED,CLC)
Entity type:Individual
Prefix:MS
First Name:GEORGIANA
Middle Name:
Last Name:CHEVRY
Suffix:
Gender:F
Credentials:MED,CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BERWICK RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-6017
Mailing Address - Country:US
Mailing Address - Phone:857-236-4819
Mailing Address - Fax:
Practice Address - Street 1:7 BERWICK RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-6017
Practice Address - Country:US
Practice Address - Phone:857-236-4819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No376J00000XNursing Service Related ProvidersHomemaker
No172V00000XOther Service ProvidersCommunity Health Worker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant