Active NPI
Elizabeth Koral
- Community Health Worker
- Malden, MA
National Provider Identifier
1235397209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 16218
- Practice address
- 40 Eastern Ave
Malden, MA 02148-5014 - Phone
- (781) 322-2600
- NPI assigned
- May 27, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 16218 | MA | Primary |
Addresses
Primary practice location
40 Eastern Ave
Malden, MA 02148-5014
Mailing address
391 Broadway Apt 104
Somerville, MA 02145-2305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16218 | MA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1235397209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "391 BROADWAY APT 104",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021452305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 EASTERN AVE",
"city": "MALDEN",
"state": "MA",
"postal_code": "021485014",
"telephone_number": "781-322-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORAL",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-27",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MA",
"license": "16218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.