Provider Demographics
NPI:1417034208
Name:TANZMAN, MASELLI & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:TANZMAN, MASELLI & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:MASELLI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:413-662-2020
Mailing Address - Street 1:151 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-4522
Mailing Address - Country:US
Mailing Address - Phone:413-662-2020
Mailing Address - Fax:413-662-2908
Practice Address - Street 1:151 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-4522
Practice Address - Country:US
Practice Address - Phone:413-662-2020
Practice Address - Fax:413-662-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9708618Medicaid
MA9708618Medicaid