Provider Demographics
NPI:1578521415
Name:BIZINKAUSKAS, PAUL A (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:BIZINKAUSKAS
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 1:64 WATERS EDGE
Mailing Address - Street 2:
Mailing Address - City:MARSTONS MILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02648-1429
Mailing Address - Country:US
Mailing Address - Phone:508-420-3752
Mailing Address - Fax:
Practice Address - Street 1:876 FALMOUTH RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2322
Practice Address - Country:US
Practice Address - Phone:508-775-6663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA82026207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
63428OtherPILGRIM
792297OtherUSFHP
2450363OtherAETNA
A21682OtherBCBS
082026OtherTUFTS
A21682OtherBCBS
MAA2168201Medicare PIN