Bueno, Bolivar
Bueno, Bolivar is an individual health care provider with primary practice located at 585 Lincoln St , Worcester MA 01605-1906. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Bueno, Bolivar can be contacted via phone (508) 854-3320.Contact Information
Primary practice address
585 Lincoln St
Worcester MA 01605-1906
Phone: (508) 854-3320
Fax: (508) 753-5051
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1861535031 |
|---|---|
| LBN Legal business name | Bueno, Bolivar |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1861535031 | NPPES |
| Massachusetts | MEDICAID | 1308785 | |
| Massachusetts | MEDICAID | 1306421 |
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