Provider Demographics
NPI:1790792828
Name:BRISTOL DIABETES & ENDOCRINOLOGY
Entity Type:Organization
Organization Name:BRISTOL DIABETES & ENDOCRINOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-821-9400
Mailing Address - Street 1:2005 BAY ST
Mailing Address - Street 2:SUITE 204B
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1085
Mailing Address - Country:US
Mailing Address - Phone:508-821-9400
Mailing Address - Fax:508-821-9151
Practice Address - Street 1:2005 BAY ST
Practice Address - Street 2:SUITE 204B
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-1085
Practice Address - Country:US
Practice Address - Phone:508-821-9400
Practice Address - Fax:508-821-9151
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
MA79137174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty