Provider Demographics
NPI:1760607808
Name:BARZILAI, DAVID (MD, PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BARZILAI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 MAIN ST STE G6
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1992
Mailing Address - Country:US
Mailing Address - Phone:781-729-4878
Mailing Address - Fax:781-729-5989
Practice Address - Street 1:955 MAIN ST STE G6
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1992
Practice Address - Country:US
Practice Address - Phone:781-729-4878
Practice Address - Fax:781-729-5989
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238470207N00000X
RILP00867207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA753412OtherTUFTS HEALTH PLAN
MAJ46043OtherBLUE CROSS BLUE SHIELD OF MA
46807OtherHEALTH NEW ENGLAND
238470OtherCONNECTICARE
46807OtherHEALTH NEW ENGLAND