Healthcare Provider Details

I. General information

NPI: 1235835992
Provider Name (Legal Business Name): MR. CHRISTOPHER MCGLOIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON ST.
TAUNTON MA
02780
US

IV. Provider business mailing address

1 WASHINGTON ST.
TAUNTON MA
02780
US

V. Phone/Fax

Practice location:
  • Phone: 401-663-3339
  • Fax:
Mailing address:
  • Phone: 401-663-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number1235835992
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: