Provider Demographics
NPI:1366573891
Name:WELLESLEY COLLEGE HEALTH SERVICE
Entity type:Organization
Organization Name:WELLESLEY COLLEGE HEALTH SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-283-2810
Mailing Address - Street 1:106 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-8268
Mailing Address - Country:US
Mailing Address - Phone:781-283-2810
Mailing Address - Fax:781-283-3693
Practice Address - Street 1:106 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-8268
Practice Address - Country:US
Practice Address - Phone:781-283-2810
Practice Address - Fax:781-283-3693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty