Healthcare Provider Details

I. General information

NPI: 1619049657
Provider Name (Legal Business Name): HEALTHWORKS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 COMMONWEALTH AVE
DEDHAM MA
02026-1441
US

IV. Provider business mailing address

126 COMMONWEALTH AVE
DEDHAM MA
02026-1441
US

V. Phone/Fax

Practice location:
  • Phone: 781-326-6005
  • Fax: 781-326-1736
Mailing address:
  • Phone: 781-326-6005
  • Fax: 781-326-1736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number53227
License Number StateMA

VIII. Authorized Official

Name: IRENE GORANITIS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 781-326-6005