Organization
HARVARD VANGUARD MEDICAL ASSOCIATES, INC
Active
Organization
HARVARD VANGUARD MEDICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL BURNES (CHIEF EXECUTIVE OFFICER)
(617) 559-8393
Entity
Organization
Contact information
Practice address
2 ESSEX CENTER DR, 3RD FLOOR, PEABODY, MA 01960-2902
(978) 532-2800
(978) 977-4226
Mailing address
275 GROVE STREET, SUITE 3-300, NEWTON, MA 02466
(617) 559-8374
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029501
NEIGHBORHOOD HEALTH PLAN
MA
01
—
M18223
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/10/2007
Last updated
12/23/2014
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