Provider Demographics
NPI:1326021429
Name:SANZ-ALTAMIRA, PEDRO M (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:M
Last Name:SANZ-ALTAMIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1281
Mailing Address - Country:US
Mailing Address - Phone:617-479-1458
Mailing Address - Fax:617-479-3500
Practice Address - Street 1:25 MARSTON ST
Practice Address - Street 2:SUITE #301
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2310
Practice Address - Country:US
Practice Address - Phone:978-946-8230
Practice Address - Fax:978-946-8226
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80463207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0021712OtherAETNA US HEALTH
MAB20804901OtherCIGNA
MA080463OtherTUFTS HEALTH CARE
MA14360OtherHARVARD PILGRIM
MA3186873Medicaid
MAJ19263OtherBLUE CROSS BLUE SHIELD
MAG68820Medicare UPIN
MAA28399Medicare ID - Type Unspecified