Individual
STEPHEN M PEZZELLA
Active
Individual
STEPHEN M PEZZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
39310
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
PRIVATE HEALTHCARE SYSTEM
—
01
—
060047286
RAILROAD MEDICARE
—
01
—
2070944
MEDICAID WELFARE
—
05
—
2070944
—
MA
01
—
26850
CHILDRENS MEDICAL SECURIT
—
01
—
26856
HEALTHY START
—
01
—
4366873
CIGNA HEALTH PLAN
—
01
—
5030238
AETNA US HEALTHCARE
—
01
—
784067
MVP HEALTH CARE
—
01
—
918138
FIRST HEALTH
—
01
—
9900071
FALLON COMMUNITY HEALTH P
—
01
—
AA6084
HARVARD PILGRIM HEALTHCAR
—
01
—
N01759
MEDICARE B
—
Enumeration date
03/21/2006
Last updated
02/20/2009
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