Organization
INTERNAL MEDICAL ASSOCIATES-EBNHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE S. FANTES MD (CHIEF MEDICAL OFFICER)
(617) 569-5800
Entity
Organization
Contact information
Practice address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
(617) 568-4756
Mailing address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
(617) 568-4780
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/30/2007
Last updated
12/29/2020
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