Basic Information
Provider Information
NPI: 1477934172
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MASSEY
FirstName: CHRISTINA
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: MASSACHUSETTS GENERAL HOSPITAL
Address2: 55 FRUIT ST.
City: BOSTON
State: MA
PostalCode: 02114
CountryCode: US
TelephoneNumber: 6177262066
FaxNumber:  
Practice Location
Address1: MASSACHUSETTS GENERAL HOSPITAL
Address2: 55 FRUIT ST.
City: BOSTON
State: MA
PostalCode: 02114
CountryCode: US
TelephoneNumber: 6177262066
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/18/2015
LastUpdateDate: 09/20/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X  N Behavioral Health & Social Service ProvidersPsychologist 
103T00000X10683MAY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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