Provider Demographics
NPI:1184039869
Name:PAZ-LANSBERG, MARIANELLA
Entity Type:Individual
Prefix:
First Name:MARIANELLA
Middle Name:
Last Name:PAZ-LANSBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIANELLA
Other - Middle Name:
Other - Last Name:PAZ SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 HARRISON AVE FL BCD5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2905
Mailing Address - Country:US
Mailing Address - Phone:617-638-7934
Mailing Address - Fax:617-638-7965
Practice Address - Street 1:830 HARRISON AVE STE 400
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2905
Practice Address - Country:US
Practice Address - Phone:617-638-8124
Practice Address - Fax:617-414-4953
Is Sole Proprietor?:No
Enumeration Date:2014-06-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125065544207Y00000X
MA289543207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology