Individual
MRS. TERESA DEGIACOMO
Active
Individual
MRS. TERESA DEGIACOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
60424
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070016619
RAILROAD MEDICARE
—
05
—
3097994
—
MA
01
—
4292
HARVARD PILGRIM
—
01
—
724847
TUFTS
—
01
—
J12059
BCBS
MA
Enumeration date
12/02/2005
Last updated
06/19/2008
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