Provider Demographics
NPI:1477618957
Name:UNIVERSITY OF MASSACHUSETTS
Entity Type:Organization
Organization Name:UNIVERSITY OF MASSACHUSETTS
Other - Org Name:UMASS MEDICAL SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHANCELLOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-856-2107
Mailing Address - Street 1:55 LAKE AVE N
Mailing Address - Street 2:UMASS MEDICAL SCHOOL
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01655-0002
Mailing Address - Country:US
Mailing Address - Phone:508-856-6537
Mailing Address - Fax:508-856-8435
Practice Address - Street 1:309 BELMONT ST
Practice Address - Street 2:WORCESTER RECOVERY CENTER AND HOSPITAL
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1059
Practice Address - Country:US
Practice Address - Phone:508-368-4000
Practice Address - Fax:508-363-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA220163Medicare PIN