Provider Demographics
NPI:1487719985
Name:TOWN OF BRAINTREE
Entity type:Organization
Organization Name:TOWN OF BRAINTREE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGINTY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:781-794-8094
Mailing Address - Street 1:1 JFK MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184
Mailing Address - Country:US
Mailing Address - Phone:781-794-8090
Mailing Address - Fax:
Practice Address - Street 1:1 JFK MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-6425
Practice Address - Country:US
Practice Address - Phone:781-794-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11071Medicare ID - Type Unspecified