Individual
DR. MARYANN A PINGALORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
196 BOSTON AVE, SUITE 2500, MEDFORD, MA 02155
(781) 396-3856
(508) 651-0830
Mailing address
21 CRESCENT ST, NATICK, MA 01760
(508) 653-1489
(508) 651-0830
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3269
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PIW03364
BLUE CROSS BLUE SHIELD OF
MA
Enumeration date
11/27/2006
Last updated
07/08/2007
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