Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 73206 | MA |
Y | 111NI0900X | Internist | 73206 | MA |
N | 207RG0300X | Geriatric Medicine | 73206 | MA |
NPI | 1043275001 |
---|---|
Provider Name | Dr. Philip F Gaziano |
First Address | Springfield, MA 01107-1109 |
Second Address | Springfield, MA 01107-1109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 03/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
97218844 | (05) | MA |
E60213 | (02) |