Provider Demographics
NPI:1225095342
Name:FRANCIS A D'AMBROSIO, SR, M.D.
Entity Type:Organization
Organization Name:FRANCIS A D'AMBROSIO, SR, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:D'AMBROSIO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:978-534-6100
Mailing Address - Street 1:790 BARRETTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-1524
Mailing Address - Country:US
Mailing Address - Phone:978-369-9181
Mailing Address - Fax:
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-534-6100
Practice Address - Fax:978-534-3053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0120057Medicaid
MAA68133Medicare UPIN
MAM02883Medicare ID - Type Unspecified