Healthcare Provider Details

I. General information

NPI: 1962306316
Provider Name (Legal Business Name): TEAMSTERS UNION 25 HEALTH SERVICES & INSURANCE PLAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAIN STREET STE 209
CHARLESTOWN MA
02129
US

IV. Provider business mailing address

529 MAIN STREET SUITE 209
CHARLESTOWN MA
02129
US

V. Phone/Fax

Practice location:
  • Phone: 617-241-9220
  • Fax:
Mailing address:
  • Phone: 617-241-9220
  • Fax: 617-242-6950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARIA GNERRE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 617-241-9220