| Charmalie G Heller, MD | |
| 10 Gove St, East Boston, MA 02128-1920 | |
| (617) 569-5800 | |
| (617) 568-4780 | 
| Full Name | Charmalie G Heller | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 10 Gove St, East Boston, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1164401899 | NPI | - | NPPES | 
| 2016290 | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 217764 (Massachusetts) | Primary | 
| Entity Name | Internal Medical Associates-ebnhc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1558481879 PECOS PAC ID: 6103814371 Enrollment ID: O20040505000853 | 
| Entity Name | East Boston Neighborhood Health Center Corp | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1316994411 PECOS PAC ID: 9032356050 Enrollment ID: O20130513000045 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Charmalie G Heller, MD 10 Gove St, East Boston, MA 02128-1920 Ph: (617) 569-5800 | Charmalie G Heller, MD 10 Gove St, East Boston, MA 02128-1920 Ph: (617) 569-5800 | 
| Dr. Carolyn Olson Walsh, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4780 | |
| Ewa B Smoczkiewicz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4780 | |
| Beth E Wigden, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4780 | |
| Tanya Geha, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4780 | |
| Allison A Brown, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4780 | |
| Stephanie R Friend, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 |