Provider Demographics
NPI:1619965332
Name:RESCINITI, ANDREA (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:RESCINITI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 ORNAC
Mailing Address - Street 2:SUITE 435
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4181
Mailing Address - Country:US
Mailing Address - Phone:978-371-7433
Mailing Address - Fax:978-371-7431
Practice Address - Street 1:131 ORNAC
Practice Address - Street 2:SUITE 435
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-371-7433
Practice Address - Fax:978-371-7431
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA558110208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA055811OtherTUFTS
MA3034747Medicaid
MA8682OtherHARVARD
MAJ07370OtherBCBS
MA3034747Medicaid
MAJ07370Medicare ID - Type Unspecified