Organization
FENWAY COMMUNITY HEALTH CENTER, INC
Active
Parent organization
FENWAY COMMUNITY HEALTH CENTER, INC
Other names
Fenway Health Green Street
Organization subpart
Yes
Provider details
NPI number
Legal business name
FENWAY COMMUNITY HEALTH CENTER, INC
Authorized official
MOIRE DANIEL (DIRECTOR OF BILLING AND COLLECTIONS)
(617) 927-6279
Entity
Organization
Contact information
Practice address
359 GREEN ST, CAMBRIDGE, MA 02139-3334
(617) 927-6050
Mailing address
PO BOX 847492, BOSTON, MA 02284-7492
(617) 927-6050
(617) 927-5410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303546
—
MA
Enumeration date
04/26/2022
Last updated
04/26/2022
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