Provider Demographics
NPI:1629180575
Name:STEPHEN J GALIZIO MD PC
Entity Type:Organization
Organization Name:STEPHEN J GALIZIO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALIZIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:978-681-4700
Mailing Address - Street 1:555 TURNPIKE ST
Mailing Address - Street 2:SUITE 41
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5923
Mailing Address - Country:US
Mailing Address - Phone:978-681-4700
Mailing Address - Fax:978-681-6669
Practice Address - Street 1:555 TURNPIKE ST
Practice Address - Street 2:SUITE 41
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5923
Practice Address - Country:US
Practice Address - Phone:978-681-4700
Practice Address - Fax:978-681-6669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH19602Medicare UPIN
MAA31173Medicare PIN