# RICHARD A MARASA MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962090001
- **Authorized official:** RICHARD A MARASA MD (OWNER)
- **Authorized official phone:** (802) 356-0255

## Contact information

- **Practice address:** 100 CUMMINGS CTR STE 428C, BEVERLY, MA 01915-6122
- **Practice address phone:** (800) 270-2302
- **Practice address fax:** (978) 852-7099
- **Mailing address:** PO BOX 855, SPRINGFIELD, VT 05156
- **Mailing address phone:** (802) 356-0255
- **Mailing address fax:** (804) 612-5201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |

## Other

- **Enumeration date:** 01/05/2021
- **Last updated:** 05/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 15037 | MEDICAL LICENSE | NH |
| 01 | — | 282042 | MEDICAL LICENSE | MA |
| 05 | — | 3079550 | — | NH |
| 05 | — | PENDING | — | MA |