Provider Demographics
NPI:1932284148
Name:TOWN OF DANVERS
Entity Type:Organization
Organization Name:TOWN OF DANVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUBLIC HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIRANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:978-777-0001
Mailing Address - Street 1:1 SYLVAN ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2790
Mailing Address - Country:US
Mailing Address - Phone:978-777-0001
Mailing Address - Fax:978-762-0215
Practice Address - Street 1:25 STONE ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1856
Practice Address - Country:US
Practice Address - Phone:978-762-0265
Practice Address - Fax:978-762-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11O15Medicare PIN