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Organization

PEDIATRIC ASSOCIATES OF MALDEN PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIEN LAN CHANG MD (PRESIDENT)
(781) 322-5101
Entity
Organization

Contact information

Practice address
105 COMMERCIAL ST, MALDEN, MA 02148-5509
(781) 322-5101
(781) 322-5820
Mailing address
105 COMMERCIAL ST, MALDEN, MA 02148-5509
(781) 322-5101
(781) 322-5820

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
683054
TUFFY HEALTH PLAN
MA
05
9785973
MA
01
M17324
BCBS
MA
Enumeration date
12/01/2006
Last updated
07/31/2008
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