Individual
THOMAS L. FAZIO
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) 557-8700
(978) 557-8867
Mailing address
500 MERRIMACK ST, RIVERWALK, LAWRENCE, MA 01843-1756
(978) 557-8700
(978) 557-8867
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
42754
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011277
NEIGHBORHOOD HEALTH PLAN
—
01
—
042754
TUFTS HEALTH PLAN
MA
01
—
100014711
RAILROAD MEDICARE
—
01
—
1902800832
FALLON COMMUNITY HEALTH PLAN
MA
05
—
2060949
—
MA
01
—
29-00569
EVERCARE
—
01
—
30201837
NH MEDICAID
—
01
—
30259
HARVARD PILGRIM HEALTH CA
MA
01
—
3925416
CIGNA HEALTHCARE
—
01
—
4035145
AETNA NON HMO
MA
01
—
678816
HEALTHSOURCE
—
01
—
975010
NETWORK HEALTH
—
01
—
A54061
ANTHEM BLUE CROSS
NH
01
—
D11110
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/09/2005
Last updated
10/29/2013
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