Provider Demographics
NPI:1003890419
Name:BIGATELLO, LUCA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCA
Middle Name:M
Last Name:BIGATELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:690 CANTON STRET
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2329
Mailing Address - Country:US
Mailing Address - Phone:781-407-7713
Mailing Address - Fax:781-407-0998
Practice Address - Street 1:736 CAMBRIDGE STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-2782
Practice Address - Fax:781-407-0998
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA59908207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA059908OtherTUFTS HEALTH PLAN
MAJ11451OtherBCBS MA
MA3080595Medicaid
MA3080595Medicaid
MA059908OtherTUFTS HEALTH PLAN