Provider Demographics
NPI:1780774216
Name:TOWN OF WESTBOROUGH
Entity type:Organization
Organization Name:TOWN OF WESTBOROUGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUBLIC HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BACCARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-366-3045
Mailing Address - Street 1:34 W MAIN ST RM 210
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1902
Mailing Address - Country:US
Mailing Address - Phone:508-366-3045
Mailing Address - Fax:508-366-3047
Practice Address - Street 1:34 W MAIN ST RM 210
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1902
Practice Address - Country:US
Practice Address - Phone:508-366-3045
Practice Address - Fax:508-366-3047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11072Medicare PIN