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General NPI Number Information
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NPI Number | 1396967816
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Entity Type | Organization
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Legal Business Name | CITY OF MEDFORD
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 85 GEORGE P HASSETT DR
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City | MEDFORD
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State | MA
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Zip | 02155-3256
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Country | US
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Telephone | 782-393-2560
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Fax | 781-393-2562
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Provider Business Mailing Address
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Address Line | 85 GEORGE P HASSETT DR
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City | MEDFORD
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State | MA
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Zip | 02155-3256
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Country | US
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Telephone | 782-393-2560
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Fax | 781-393-2562
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Authorized Official
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Title or Position | DIRECTOR, BOARD OF HEALTH
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Name | MS. KAREN ROSE
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Credential | RN,BA,MS
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Telephone | 781-393-2560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | NA
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License Number State | MA
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