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General NPI Number Information
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NPI Number | 1699634683
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Entity Type | Organization
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Legal Business Name | BLUE CIRCLE HEALTH OF MASSACHUSETTS PC
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 56 BROAD ST STE 14281
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City | BOSTON
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State | MA
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Zip | 02109-4301
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Country | US
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Telephone | 888-404-4813
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Fax | 888-675-4061
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Provider Business Mailing Address
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Address Line | 56 BROAD ST STE 14281
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City | BOSTON
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State | MA
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Zip | 02109-4301
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Country | US
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Telephone | 888-404-4813
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Fax | 888-675-4061
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | LUCESITA SCAMMON
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Credential |
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Telephone | 413-213-2918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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