Provider Demographics
NPI:1962651075
Name:NEW BEDFORD HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:NEW BEDFORD HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:RDH,BA,MS
Authorized Official - Phone:508-991-6199
Mailing Address - Street 1:1213 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6694
Mailing Address - Country:US
Mailing Address - Phone:508-991-6199
Mailing Address - Fax:508-991-6292
Practice Address - Street 1:1213 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6694
Practice Address - Country:US
Practice Address - Phone:508-991-6199
Practice Address - Fax:508-991-6292
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF NEW BEDFORD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare