Environmental Health Center Of Martha's Vineyard | |
24 Cournoyer Rd West Tisbury MA 02575 | |
(508) 693-1300 | |
(508) 693-1305 |
Full Name | Environmental Health Center Of Martha's Vineyard |
---|---|
Speciality | General Practice |
Location | 24 Cournoyer Rd, West Tisbury, Massachusetts |
Authorized Official Name and Position | Lisa Nagy (SOLE PROPRIETOR) |
Authorized Official Contact | 5086931300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Environmental Health Center Of Martha's Vineyard 24 Cournoyer Rd Vineyard Haven MA 02568-7625 Ph: (508) 693-1300 | Environmental Health Center Of Martha's Vineyard 24 Cournoyer Rd West Tisbury MA 02575 Ph: (508) 693-1300 |
NPI Number | 1275894875 |
---|---|
Provider Enumeration Date | 05/31/2012 |
Last Update Date | 11/25/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275894875 | NPI | - | NPPES |
11009334A | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 72590 (Massachusetts) | Primary |