Iandoli, Bryan P
Iandoli, Bryan P is an sole proprietor health care provider with primary practice located at 881 South St Suite #5, Fitchburg MA 01420-6252. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Iandoli, Bryan P can be contacted via phone (978) 343-4747.Contact Information
Primary practice address
881 South St Suite #5
Fitchburg MA 01420-6252
Phone: (978) 343-4747
Fax: (978) 343-4729
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6208 | Massachusetts |
Profile Details
| NPI number | 1922173830 |
|---|---|
| LBN Legal business name | Iandoli, Bryan P |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 24th, 2006 |
| Last updated | May 12th, 2015 - about 10 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 | 1922173830 | NPPES |
| Massachusetts | MEDICAID | 0521744 |
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