Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 25823 | MA |
NPI | 1134168222 |
---|---|
Provider Name | Frank T Dimasi |
First Address | Revere, MA 02151-3143 |
Second Address | Revere, MA 02151-3143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 08/07/2007 |