Provider Demographics
NPI:1578553848
Name:ZUSKY, PAUL MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MATTHEW
Last Name:ZUSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:MATTHEW
Other - Last Name:ZUSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-5600
Mailing Address - Fax:617-726-7541
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC 8 PSYCHIATRY-OUTPATIENT DEPART
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-724-5600
Practice Address - Fax:617-726-7541
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA47479207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB02126OtherBCBS MA
MA715489OtherTUFTS HEALTH PLAN
MA2088495Medicaid
Z56692Medicare UPIN
MAB02126Medicare ID - Type Unspecified