Provider Demographics
NPI:1780606608
Name:NORTH END COMMUNITY HEALTH COMMITTEE INC
Entity type:Organization
Organization Name:NORTH END COMMUNITY HEALTH COMMITTEE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIBELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-643-8082
Mailing Address - Street 1:332 HANOVER STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113
Mailing Address - Country:US
Mailing Address - Phone:617-643-8000
Mailing Address - Fax:617-643-8127
Practice Address - Street 1:332 HANOVER STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113
Practice Address - Country:US
Practice Address - Phone:617-643-8000
Practice Address - Fax:617-643-8127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41432083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300253Medicaid
MA1300253Medicaid
MAY10145Medicare ID - Type UnspecifiedMA MEDICARE #