1770681066 NPI number — DR. THOMAS SBARRA M.D.

Table of content: DR. THOMAS SBARRA M.D. (NPI 1770681066)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770681066 NPI number — DR. THOMAS SBARRA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SBARRA
Provider First Name:
THOMAS
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770681066
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
90 TER HEUN DR
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
FALMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02540-2533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-540-0604
Provider Business Mailing Address Fax Number:
508-457-0129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 TER HEUN DR
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
FALMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02540-2533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-540-0604
Provider Business Practice Location Address Fax Number:
508-457-0129
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  39813 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 060058503 . This is a "MEDICARE ID" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2098679 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25-00642 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 060058503 . This is a "TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1770681066 . This is a "GREAT WEST HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: C24029 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2276072 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3006 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0038769 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 11089322 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1770681066 . This is a "UNICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: B20978201 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0000279026 . This is a "HMSA BILLING NUMBERS" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 71828 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000029654 . This is a "BOSTON MEDICAL CENTER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1770681066 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 623266-01 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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