Provider Demographics
NPI:1851465538
Name:TOWN OF STONEHAM
Entity Type:Organization
Organization Name:TOWN OF STONEHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF HEALTH CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:781-279-2621
Mailing Address - Street 1:35 CENTRAL STREET
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180
Mailing Address - Country:US
Mailing Address - Phone:781-279-2621
Mailing Address - Fax:781-279-2615
Practice Address - Street 1:35 CENTRAL STREET
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180
Practice Address - Country:US
Practice Address - Phone:781-279-2621
Practice Address - Fax:781-279-2615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare