Provider Demographics
NPI:1447317482
Name:CITY OF MALDEN
Entity type:Organization
Organization Name:CITY OF MALDEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUBLIC HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JAME
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-397-7053
Mailing Address - Street 1:200 PLEASANT STREET
Mailing Address - Street 2:ROOM 517
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148
Mailing Address - Country:US
Mailing Address - Phone:781-397-7053
Mailing Address - Fax:781-397-7350
Practice Address - Street 1:200 PLEASANT ST
Practice Address - Street 2:ROOM 517
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-4802
Practice Address - Country:US
Practice Address - Phone:781-397-7053
Practice Address - Fax:781-397-7350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y11121Medicare ID - Type Unspecified