Individual
DREW G. NICCOLINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 MERRIMACK ST, RIVERWALK, LAWRENCE, MA 01843-1756
(978) 557-8900
(978) 557-8867
Mailing address
500 MERRIMACK ST, RIVERWALK, LAWRENCE, MA 01843-1756
(978) 557-8900
(978) 557-8867
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
39361
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000292
NH MEDICAID
NH
01
—
0011285
NEIGHBORHOOD HEALTH PLAN
—
01
—
039361
TUFTS HEALTH PLAN
MA
01
—
100014709
RAILROAD MEDICARE
—
05
—
110036482A
—
MA
01
—
1639174410
AETNA HMO
MA
05
—
2040646
—
MA
01
—
29-00574
EVERCARE
—
01
—
30261
HARVARD PILGRIM HEALTHCAR
MA
01
—
4035488
AETNA NON HMO
MA
01
—
5919450
CIGNA HEALTHCARE
—
01
—
678810
HEALTHSOURCE
—
01
—
976795
NETWORK HEALTH
—
01
—
A54064
ANTHEM BLUE CROSS
NV
01
—
D11109
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/17/2005
Last updated
11/19/2012
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