Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 231313 | MA |
N | 208600000X | Surgeon | 231313 | MA |
N | 2086S0120X | Pediatric Surgery | 231313 | MA |
Y | 2088P0231X | Pediatric Urologist | 231313 | MA |
NPI | 1265414551 |
---|---|
Provider Name | Dr. Rafael Vicente Pieretti |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 11/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
469154 | TUFTS HEALTH PLAN (01) | MA |
I10549 | (02) | |
J28160 | BCBS MA (01) | MA |