Organization
MERRIMACK VALLEY ENDOSCOPY CENTER TDI
Active
Parent organization
MERRIMACK VALLEY ENDOSCOPY CENTER TDI
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERRIMACK VALLEY ENDOSCOPY CENTER TDI
Authorized official
DR. THOMAS L FAZIO MD (MANAGING PARTNER)
(978) 521-3235
Entity
Organization
Contact information
Practice address
1 PARKWAY, HAVERHILL, MA 01830-6278
(978) 521-3235
(978) 521-3236
Mailing address
1 PARKWAY, HAVERHILL, MA 01830-6278
(978) 521-3235
(978) 521-3235
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040569
BLUE CROSS BLUE SHIELD OF
MA
Enumeration date
07/20/2007
Last updated
07/20/2007
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