MEDICARE: PETER GOLDRING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	104746	MA

General Provider Information

NPI Number	:	1003894155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER GOLDRING

Provider Business Mailing Address
First Line	:	22 OAK HILL RD
Second Line	:
City	:	NATICK
State	:	MA
Zip	:	01760-1028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 COLONIAL AVE
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02460-1215
Country	:	US
Telephone Number	:	800-286-4165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2006
Last Update Date	:	07/08/2007

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Directions to “ PETER GOLDRING ” Practice Location

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