Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 59908 | MA |
NPI | 1003890419 |
---|---|
Provider Name | Dr. Luca M Bigatello |
First Address | Westwood, MA 02090-2329 |
Second Address | Boston, MA 02135-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 30/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
059908 | TUFTS HEALTH PLAN (01) | MA |
3080595 | (05) | MA |
E94240 | (02) | |
J11451 | BCBS MA (01) | MA |