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Individual

DR. MARTIN A ACQUADRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
736 CAMBRIDGE ST, BRIGHTON, MA 02135-2907
(617) 789-3023
Mailing address
BMCHS PROVIDER ENROLLMENT, 960 MASSACHUSETTS AVE FLR 2, BOSTON, MA 02118
(508) 798-8012

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
54006
MA
208VP0000X
Pain Medicine Physician
54006
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
054006
TUFTS HEALTH PLAN
MA
05
3124517
MA
01
J08549
BCBS MA
MA
Enumeration date
11/08/2005
Last updated
03/14/2025
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