Migdole, Samuel Mark
Migdole, Samuel Mark is an sole proprietor health care provider with primary practice located at 23 Broadway , Beverly MA 01915-4417. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Migdole, Samuel Mark can be contacted via phone (978) 922-2280.Contact Information
Primary practice address
23 Broadway
Beverly MA 01915-4417
Phone: (978) 922-2280
Fax: (978) 927-1758
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 76 | Massachusetts |
Profile Details
| NPI number | 1407932338 |
|---|---|
| LBN Legal business name | Migdole, Samuel Mark |
| Credentials | ED.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407932338 | NPPES |
| Massachusetts | Other | 97964101 | NETWORK HEALTH |
| Massachusetts | Other | 901877 | NETWORK HEALTH |
| Massachusetts | Other | WO1232 | NETWORK HEALTH |
| Massachusetts | MEDICAID | 1302892 | NETWORK HEALTH |
| Massachusetts | Other | 096083 | NETWORK HEALTH |
| Massachusetts | Other | 1010630 | NETWORK HEALTH |
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