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Organization
PENTUCKET MEDICAL ASSOCIATES, LLC
Active
Organization
PENTUCKET MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS LOUIS FAZIO M.D. (MANAGING PARTNER)
(978) 557-8920
Entity
Organization
Contact information
Practice address
ONE PARKWAY, HAVERHILL, MA 01830
(978) 521-3200
(978) 469-5363
Mailing address
ONE PARKWAY, HAVERHILL, MA 01830
(978) 521-3200
(978) 374-9792
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018028
NEIGHBORHOOD HEALTH PLAN
MA
01
—
30210443
NH MEDICAID
NH
01
—
5313652
AETNA
—
01
—
681017
TUFTS
MA
05
—
9786376
—
MA
01
—
M17320
BCBS
MA
Enumeration date
06/22/2005
Last updated
06/15/2011
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