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Ms. Dorothy Joan Bergold, LICSW
Primary Care Clinic/Center in Revere, Massachusetts
NPI 1902389463

Dorothy Joan Bergold is a Primary Care Clinic/Center based in Stoneham, MA and is specialized in Primary Care. Dorothy Joan Bergold practices in Revere, MA and has the professional credentials of LICSW. The NPI Number for Dorothy Joan Bergold is 1902389463 and holds a License No. 105125 (Massachusetts).

The current practice location address for Dorothy Joan Bergold is 385 Broadway, Revere, MA and can be reached out via phone at 781-485-1000.

Location: 385 Broadway, Revere, MA, 02180-2441
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902389463
Provider Name
Dorothy Joan Bergold
Credential
LICSW
Provider Entity Type
Individual
Gender
Female
Address
385 Broadway, Revere, MA, 02180-2441
Phone Number
781-485-1000
Fax Number
Provider Enumeration Date
09/11/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
385 Broadway
City
Revere
State
Massachusetts
Zip
02151-3033
Phone Number
781-485-1000
Fax Number
person
Provider Business Mailing Address Details
Address
385 Broadway
City
Revere
State
Massachusetts
Zip
02151-3033
Phone Number
781-485-1000
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
105125 (Massachusetts)
Definition
Definition to come...
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