Organization
PENTUCKET MEDICAL ASSOCIATES LLC
Active
Organization
PENTUCKET MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS FAZIO (MANAGING PARTNER)
(978) 469-5586
Entity
Organization
Contact information
Practice address
1 PARKWAY, HAVERHILL, MA 01830-6278
(978) 469-3203
(978) 469-5378
Mailing address
1 PARKWAY, HAVERHILL, MA 01830-6278
(978) 469-3203
(978) 469-5378
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2469
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034962
NEIGHBORHOOD HEALTH PLAN
MA
01
—
018466
MASS. BLUE CROSS
MA
05
—
0800147
—
MA
01
—
807895
TUFTS HEALTH PLAN
MA
Enumeration date
02/03/2006
Last updated
01/15/2008
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