MEDICARE: TOWN OF CANTON

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	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1417161274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF CANTON

Provider Business Mailing Address
First Line	:	79 PLEASANT ST
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-2231
Country	:	US
Telephone Number	:	781-821-5021
Fax Number	:	781-821-0337

Provider Business Practice Location Address
First Line	:	79 PLEASANT ST
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-2231
Country	:	US
Telephone Number	:	781-821-5021
Fax Number	:	781-821-0337

Authorized Official
Title or Position	:	DIRECTOR OF HEALTH DEPT
Name	:	MR. JOHN CICCOTTELLI
Credential	:
Telephone Number	:	781-821-5021

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	08/22/2020

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Directions to “TOWN OF CANTON ” Practice Location

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