Provider Demographics
NPI:1588831895
Name:FRANK TWAROGMD,CURTIS MOODY,MDPTRS
Entity Type:Organization
Organization Name:FRANK TWAROGMD,CURTIS MOODY,MDPTRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:TWAROG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-369-3567
Mailing Address - Street 1:1 BROOKLINE PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7224
Mailing Address - Country:US
Mailing Address - Phone:617-735-8750
Mailing Address - Fax:617-735-8752
Practice Address - Street 1:86 BAKER AVENUE EXT STE 304
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2132
Practice Address - Country:US
Practice Address - Phone:978-369-3567
Practice Address - Fax:978-369-5811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34521174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2025663Medicaid
MAB76734Medicare UPIN