Provider Demographics
NPI:1780710376
Name:ANDERSON, FRANK GUASTELLA (MD)
Entity type:Individual
Prefix:
First Name:FRANK GUASTELLA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1222
Mailing Address - Country:US
Mailing Address - Phone:978-371-7474
Mailing Address - Fax:
Practice Address - Street 1:70 JUNCTION SQUARE DR # A
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3049
Practice Address - Country:US
Practice Address - Phone:978-371-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA788912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry