Provider Demographics
NPI:1376707232
Name:MADAN ZUTSHI, P.C.
Entity Type:Organization
Organization Name:MADAN ZUTSHI, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MADAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZUTSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-389-6033
Mailing Address - Street 1:92 GARLAND ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-5067
Mailing Address - Country:US
Mailing Address - Phone:508-949-8118
Mailing Address - Fax:508-461-0013
Practice Address - Street 1:92 GARLAND ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-5067
Practice Address - Country:US
Practice Address - Phone:617-389-6033
Practice Address - Fax:617-389-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA61557OtherHARVARD PILGRIM
MAM08636OtherBLUECROSS
MA2033739Medicaid
MA702802OtherTUFTS
MAM08636Medicare UPIN