Provider Demographics
NPI:1346213105
Name:GARFINKLE, TERRY J (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:J
Last Name:GARFINKLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 BRADLEE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907
Mailing Address - Country:US
Mailing Address - Phone:781-599-3299
Mailing Address - Fax:
Practice Address - Street 1:55 HIGHLAND AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-745-6601
Practice Address - Fax:978-744-4872
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49306207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0164178Medicaid
MA2084840OtherAETNA NUMBER
MA35395OtherFALLON
MA703640OtherTUFTS NUMBER
MA0012292OtherNEIGHBORHOOD HEALTH NUMBE
MA040004209OtherRR MEDICARE NUMBER
MA19309OtherHPHC NUMBER
MAD25082OtherBLUE SHIELD NUMBER
MA1000056OtherUNITED HEALTH CARE NUMBER
MA040004209OtherRR MEDICARE NUMBER
MAD25082Medicare ID - Type UnspecifiedMEDICARE NUMBER