| Eleanor Health Professional Fl Pllc | |
|
221 Crescent St Ste 202 Waltham MA 02453-3425 | |
| (919) 765-8744 | |
| Not Available |
| Full Name | Eleanor Health Professional Fl Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 221 Crescent St Ste 202, Waltham, Massachusetts |
| Authorized Official Name and Position | Nzginga Harrison (CO-FOUNDER) |
| Authorized Official Contact | 6174190858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eleanor Health Professional Fl Pllc 221 Crescent St Ste 202 Waltham MA 02453-3425 Ph: (919) 765-8744 | Eleanor Health Professional Fl Pllc 221 Crescent St Ste 202 Waltham MA 02453-3425 Ph: (919) 765-8744 |
| NPI Number | 1144940735 |
|---|---|
| Provider Enumeration Date | 09/01/2022 |
| Last Update Date | 09/01/2022 |
| Certification Date | 09/01/2022 |
| Medicare PECOS PAC ID | 2365806171 |
|---|---|
| Medicare Enrollment ID | O20230913000261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144940735 | NPI | - | NPPES |
| Provider Name | Nzinga Ajabu Harrison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518099910 PECOS PAC ID: 5698793875 Enrollment ID: I20230913000361 |
| Provider Name | Marisa Savic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548875875 PECOS PAC ID: 4183036379 Enrollment ID: I20230925000778 |
| Provider Name | Crystal Ann Randolph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811463797 PECOS PAC ID: 3072924463 Enrollment ID: I20230926000581 |
| Provider Name | Holly Bard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265054076 PECOS PAC ID: 4688086218 Enrollment ID: I20230926000768 |
| Provider Name | Stephen William North |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073611091 PECOS PAC ID: 3476527300 Enrollment ID: I20231030002535 |
| Provider Name | Logan Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164889044 PECOS PAC ID: 2668779489 Enrollment ID: I20231101000025 |
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