MEDICARE: DR. W. VINCENT PERRELLI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	32113	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902806219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. W. VINCENT PERRELLI MD

Provider Business Mailing Address
First Line	:	8 COMMON ST
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-4421
Country	:	US
Telephone Number	:	781-647-3040
Fax Number	:	781-647-3044

Provider Business Practice Location Address
First Line	:	671 MAIN ST
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-0602
Country	:	US
Telephone Number	:	781-647-3040
Fax Number	:	781-647-3044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	01/04/2010

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