Individual
DR. GREGORY A BAZYLEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 SCHOOL STREET, MANCHESTER, MA 01944
(978) 526-4311
(978) 525-2342
Mailing address
195 SCHOOL STREET, MANCHESTER, MA 01944
(978) 526-4311
(978) 525-2342
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45749
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126632
—
MA
01
—
045749
TUFTS
MA
01
—
BAD16009
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/26/2006
Last updated
03/30/2010
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