Provider Demographics
NPI:1407827538
Name:BAPTISTA, VERONICA N (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:N
Last Name:BAPTISTA
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 1:26 CITY HALL MALL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4754
Mailing Address - Country:US
Mailing Address - Phone:617-421-1091
Mailing Address - Fax:781-306-5080
Practice Address - Street 1:26 CITY HALL MALL
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4754
Practice Address - Country:US
Practice Address - Phone:617-421-1091
Practice Address - Fax:781-306-5080
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221213207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ27992OtherBLUE CROSS
MA469662OtherTUFTS
MA2082021Medicaid
MAAA17099OtherHARVARD PILGRIM
MAAA17099OtherHARVARD PILGRIM
MA2082021Medicaid