Provider Demographics
NPI:1760521546
Name:TOWN OF COHASSET
Entity Type:Organization
Organization Name:TOWN OF COHASSET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH INSPECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:N
Authorized Official - Last Name:TRADD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-383-4116
Mailing Address - Street 1:41 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1822
Mailing Address - Country:US
Mailing Address - Phone:781-383-2210
Mailing Address - Fax:781-383-4111
Practice Address - Street 1:41 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1822
Practice Address - Country:US
Practice Address - Phone:781-383-2210
Practice Address - Fax:781-383-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11043Medicare ID - Type UnspecifiedMEDICARE PROVIDER