Provider Demographics
NPI:1497760052
Name:UNIVERSITY HEALTH SERVICES
Entity Type:Organization
Organization Name:UNIVERSITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS NP
Authorized Official - Phone:617-287-5660
Mailing Address - Street 1:89 WALNUT ST
Mailing Address - Street 2:#5
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1333
Mailing Address - Country:US
Mailing Address - Phone:617-964-4162
Mailing Address - Fax:
Practice Address - Street 1:100 WILLIAM T MORRISSEY BLVD
Practice Address - Street 2:QUINN ADMINISTRATION BUILDING
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-3300
Practice Address - Country:US
Practice Address - Phone:617-287-5660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA137670261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center