Provider Demographics
NPI:1558327536
Name:PRIZZI, ANTHONY RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:RICHARD
Last Name:PRIZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GLEASON STREET
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-775-0667
Mailing Address - Fax:508-775-6358
Practice Address - Street 1:20 GLEASON STREET
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-775-0667
Practice Address - Fax:508-775-6358
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA29327208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A59757Medicare UPIN
M13786Medicare ID - Type UnspecifiedGROUP
MA9730516Medicare ID - Type Unspecified
215064Medicare ID - Type UnspecifiedIND