Provider Demographics
NPI:1669567616
Name:WOMEN'S HEALTH OF CENTRAL MA. PC
Entity type:Organization
Organization Name:WOMEN'S HEALTH OF CENTRAL MA. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-755-4861
Mailing Address - Street 1:328 SHREWSBURY ST
Mailing Address - Street 2:STE 100
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4613
Mailing Address - Country:US
Mailing Address - Phone:508-755-4861
Mailing Address - Fax:
Practice Address - Street 1:328 SHREWSBURY ST
Practice Address - Street 2:STE 100
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4613
Practice Address - Country:US
Practice Address - Phone:508-755-4861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9712828Medicaid
MA691534OtherTUFTS
MAM17958OtherBLUE CROSS BLUE SHEILD
MA53149OtherFALLON
MA53149OtherFALLON