1730284894 NPI number — WILLIAM J BYRNE, INC.

Table of content: MARIA D MCANANICH OT (NPI 1437163011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730284894 NPI number — WILLIAM J BYRNE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM J BYRNE, 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:
1730284894
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATICK
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01760-4530
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-655-3656
Provider Business Mailing Address Fax Number:
508-655-2473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATICK
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01760-4530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-655-3656
Provider Business Practice Location Address Fax Number:
508-655-2473
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BYRNE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
508-655-3656

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: 180654 . This is a "BC/BS OF MASSACHUSETTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1524259 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com