MEDICARE: DELYAN SAVOV

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	214263	MA

General Provider Information

NPI Number	:	1386844314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELYAN SAVOV

Provider Business Mailing Address
First Line	:	77 B WARREN ST
Second Line	:	77 B WARREN ST
City	:	BRIGHTON
State	:	ME
Zip	:	02135
Country	:	US
Telephone Number	:	617-787-1901
Fax Number	:	617-254-3461

Provider Business Practice Location Address
First Line	:	10 PALMER CT
Second Line	:
City	:	EAST FREETOWN
State	:	MA
Zip	:	02717
Country	:	US
Telephone Number	:	617-787-1901
Fax Number	:

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

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/18/2007

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