Provider Demographics
NPI:1629377023
Name:FABRIZIO, ANNE (MD,)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:FABRIZIO
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 1:330 BROOKLINE AVE # GZ-605
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-4159
Mailing Address - Fax:617-667-2978
Practice Address - Street 1:330 BROOKLINE AVE # GZ-605
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-4159
Practice Address - Fax:617-667-2978
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA281240208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery