Individual
DR. FREDERICK CALVIN BASILICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 PARKER HILL AVE, STE 450, ROXBURY CROSSING, MA 02120-2847
(617) 754-5910
(617) 754-5950
Mailing address
125 PARKER HILL AVE, STE 450, ROXBURY CROSSING, MA 02120-2847
(617) 754-5910
(617) 754-5950
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
41593
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100153
—
MA
01
—
2500051
UNITED HEALTH CARE
—
01
—
3039
HARVARD PILGRIM HEALTHCAR
—
Enumeration date
07/18/2005
Last updated
12/15/2009
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