MEDICARE: GREGORY PAMPHILE

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	000121469	MA

General Provider Information

NPI Number	:	1629426390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY PAMPHILE

Provider Business Mailing Address
First Line	:	532 PAGE ST
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-6003
Country	:	US
Telephone Number	:	774-240-6827
Fax Number	:	617-829-9596

Provider Business Practice Location Address
First Line	:	532 PAGE ST
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-6003
Country	:	US
Telephone Number	:	774-240-6827
Fax Number	:	617-829-9596

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

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	02/28/2024

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Directions to “ GREGORY PAMPHILE ” Practice Location

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