1053373845 NPI number — JOHN CURELLI

Table of content: (NPI 1053373845)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053373845 NPI number — JOHN CURELLI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN CURELLI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053373845
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 OLD SCHOOLHOUSE VILLAGE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VINEYARD HAVEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-693-4380
Provider Business Mailing Address Fax Number:
508-696-9350

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
459 STATE RD
Provider Second Line Business Practice Location Address:
UNIT 19
Provider Business Practice Location Address City Name:
VINEYARD HAVEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02568
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-693-4380
Provider Business Practice Location Address Fax Number:
508-629-5656
Provider Enumeration Date:
04/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CURELLI
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
508-693-4380

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1521543 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1537792 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 395854 . This is a "BLUE CROSS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com