1902972599 NPI number — DR. DANIEL N BIZER D.M.D.

Table of content: DR. DANIEL N BIZER D.M.D. (NPI 1902972599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902972599 NPI number — DR. DANIEL N BIZER D.M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIZER
Provider First Name:
DANIEL
Provider Middle Name:
N
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.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:
1902972599
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 BRASSIE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH READING
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01864-3435
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-664-0012
Provider Business Mailing Address Fax Number:
978-664-1575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 CABOT PL
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
STOUGHTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02072-4612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-436-8770
Provider Business Practice Location Address Fax Number:
781-436-8772
Provider Enumeration Date:
11/27/2006

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: 207L00000X , with the licence number:  10482 , 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: 0267465 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: X2044 . This is a "MEDICARE PTAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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