Provider Demographics
NPI:1053309682
Name:PALAZZO, VIRGINIA H (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:H
Last Name:PALAZZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:48 ROBINWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1114
Mailing Address - Country:US
Mailing Address - Phone:617-864-8822
Mailing Address - Fax:617-491-4692
Practice Address - Street 1:725 CONCORD AVE
Practice Address - Street 2:SUITE 4100
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1040
Practice Address - Country:US
Practice Address - Phone:617-864-8822
Practice Address - Fax:617-547-5367
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA58564207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3039242Medicaid
MAA66647Medicare UPIN
MAJ07567Medicare ID - Type Unspecified