Provider Demographics
NPI:1134706567
Name:TOWN OF WILBRAHAM
Entity type:Organization
Organization Name:TOWN OF WILBRAHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CONSELINO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:413-596-2800
Mailing Address - Street 1:240 SPRINGFIELD ST
Mailing Address - Street 2:WILBRAHAM TOWN HALL
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095
Mailing Address - Country:US
Mailing Address - Phone:413-596-2800
Mailing Address - Fax:413-596-9256
Practice Address - Street 1:240 SPRINGFIELD ST
Practice Address - Street 2:WILBRAHAM TOWN HALL
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095
Practice Address - Country:US
Practice Address - Phone:413-596-2800
Practice Address - Fax:413-596-9256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service