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General NPI Number Information
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NPI Number | 1962306316
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Entity Type | Organization
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Legal Business Name | TEAMSTERS UNION 25 HEALTH SERVICES & INSURANCE PLAN
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 529 MAIN STREET STE 209
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City | CHARLESTOWN
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State | MA
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Zip | 02129
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Country | US
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Telephone | 617-241-9220
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Fax |
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Provider Business Mailing Address
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Address Line | 529 MAIN STREET SUITE 209
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City | CHARLESTOWN
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State | MA
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Zip | 02129
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Country | US
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Telephone | 617-241-9220
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Fax | 617-242-6950
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARIA GNERRE
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Credential |
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Telephone | 617-241-9220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | NULL
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