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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