Basic Information
| Provider Information | |||||||||
| NPI: | 1194027169 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WINDSOR HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 119 WINDSOR ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021393647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176653600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 119 WINDSOR ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021393647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176653600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2010 | ||||||||
| LastUpdateDate: | 11/24/2010 | ||||||||
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| AuthorizedOfficialLastName: | HUDD | ||||||||
| AuthorizedOfficialFirstName: | JOAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | GENERAL DUTY NURSE | ||||||||
| AuthorizedOfficialTelephone: | 6176653600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 117008 | MA | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.