Provider Demographics
NPI:1972303188
Name:PINEDA GONZLAEZ, MARIELIZ
Entity type:Individual
Prefix:
First Name:MARIELIZ
Middle Name:
Last Name:PINEDA GONZLAEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 EUSTIS ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-3800
Mailing Address - Country:US
Mailing Address - Phone:781-400-9417
Mailing Address - Fax:
Practice Address - Street 1:302 EUSTIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-3800
Practice Address - Country:US
Practice Address - Phone:781-400-9417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator