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General NPI Number Information
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NPI Number | 1487082228
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Entity Type | Organization
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Legal Business Name | EDWARD M KENNEDY COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 354 WAVERLY ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-7079
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Country | US
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Telephone | 508-270-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 115 NE CUTOFF STE 200
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City | WORCESTER
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State | MA
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Zip | 01606-1224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. STEPHEN J KERRIGAN
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Credential |
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Telephone | 508-854-2122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2280076
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License Number State | MA
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