Provider Demographics
NPI:1518974682
Name:PEGGY HOWRIGAN MD PC
Entity Type:Organization
Organization Name:PEGGY HOWRIGAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOWRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-237-5085
Mailing Address - Street 1:460 TOTTEN POND ROAD
Mailing Address - Street 2:CIO MZI
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1906
Mailing Address - Country:US
Mailing Address - Phone:781-890-9933
Mailing Address - Fax:781-890-9950
Practice Address - Street 1:65 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:781-237-5085
Practice Address - Fax:781-237-5087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48032208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM16139OtherBCBS
MAM16139OtherBCBS