Provider Demographics
NPI:1831180058
Name:PIZZUTO, JOHN ANTHONY (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:PIZZUTO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1168 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-4763
Mailing Address - Country:US
Mailing Address - Phone:978-957-9800
Mailing Address - Fax:978-957-3700
Practice Address - Street 1:1168 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-4763
Practice Address - Country:US
Practice Address - Phone:978-957-9800
Practice Address - Fax:978-957-3700
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1904213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB20353301OtherCIGNA
MA27-00025OtherUNITED HEALTHCARE
MA001904OtherTUFTS HEALTH PLAN
MAS022786OtherCHAMPUS/TRICARE
MA0362867Medicaid
MAY70900OtherBLUE SHIELD OF MA
MA22257OtherFALLON HEALTH PLAN
MA33728OtherHARVARD PILGRIM HEALTH
MAY70900OtherBLUE SHIELD OF MA
MAB20353301OtherCIGNA
MA480008798Medicare PIN