Wald, Deborah Jean

Wald, Deborah Jean is an individual health care provider with primary practice located at 300 Ocean Ave Rhc Revere Healthcare Center, Revere MA 02151-3675. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Wald, Deborah Jean can be contacted via phone (617) 485-6350.

Contact Information

Primary practice address
300 Ocean Ave Rhc Revere Healthcare Center Revere MA 02151-3675
Phone: (617) 485-6350
Fax: (617) 485-6391
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 79608 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 79608 Massachusetts

Profile Details

NPI number 1124019039
LBN Legal business name Wald, Deborah Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124019039 NPPES
Massachusetts Other 724447 TUFTS HEALTH PLAN
Massachusetts Other J31234 TUFTS HEALTH PLAN
Massachusetts MEDICAID 3138968 TUFTS HEALTH PLAN

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