Individual
EILEEN E MALTAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY, WORCESTER, MA 01655-0002
(508) 334-3271
(508) 856-5911
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
230650
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2132869
—
MA
Enumeration date
12/08/2006
Last updated
11/24/2020
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