Provider Demographics
NPI:1376538355
Name:BAYER-ZWIRELLO, LUCY A (MD)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:A
Last Name:BAYER-ZWIRELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE ST
Mailing Address - Street 2:SMC 7TH FLOOR
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2907
Mailing Address - Country:US
Mailing Address - Phone:617-562-7026
Mailing Address - Fax:617-779-6783
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:SMC 7TH FLOOR
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-562-7026
Practice Address - Fax:617-779-6783
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72626207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3067360Medicaid
C35551Medicare UPIN
MAJ11859Medicare ID - Type Unspecified