Healthcare Provider Details

I. General information

NPI: 1760484703
Provider Name (Legal Business Name): HARVEY ALLEN TAYLOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 FREMONT ST
MARLBORO MA
01752-1271
US

IV. Provider business mailing address

65 FREMONT ST
MARLBORO MA
01752-1271
US

V. Phone/Fax

Practice location:
  • Phone: 508-485-1079
  • Fax: 508-485-0899
Mailing address:
  • Phone: 508-485-1079
  • Fax: 508-485-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: