1588838452 NPI number — NEW DIMENSIONS IN HEALTH INC

Table of content: (NPI 1588838452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588838452 NPI number — NEW DIMENSIONS IN HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW DIMENSIONS IN HEALTH INC
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:
6
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:
1588838452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 ASBURY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH HAMILTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01982-1808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-269-6262
Provider Business Mailing Address Fax Number:
617-269-1068

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 ASBURY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH HAMILTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01982-1808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-269-6262
Provider Business Practice Location Address Fax Number:
617-269-1068
Provider Enumeration Date:
04/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HERSHBERG
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
DALE
Authorized Official Title or Position:
DIRECTOR/OWNER
Authorized Official Telephone Number:
617-269-6262

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  264 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6440025 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y65611 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4598099 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 603413 . This is a "HPHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 10230200 . This is a "ACS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 8211 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: PT0047 . This is a "MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 718592 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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