Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 25480 | MA |
Y | 213ES0000X | Sports Medicine | 25480 | MA |
NPI | 1316514144 |
---|---|
Provider Name | Brian Tranfaglia |
First Address | Mattapoisett, MA 02739-1522 |
Second Address | New Bedford, MA 02745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2021 |
Last Update Date | 09/06/2021 |