1033111646 NPI number — ROBERT P CIPRO MD

Table of content: ROBERT P CIPRO MD (NPI 1033111646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033111646 NPI number — ROBERT P CIPRO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CIPRO
Provider First Name:
ROBERT
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1033111646
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
198 MASSACHUSETTS AVE
Provider Second Line Business Mailing Address:
#103
Provider Business Mailing Address City Name:
N ANDOVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01845-4143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-685-7550
Provider Business Mailing Address Fax Number:
978-686-5565

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
198 MASSACHUSETTS AVE
Provider Second Line Business Practice Location Address:
#103
Provider Business Practice Location Address City Name:
N ANDOVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01845-4143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-685-7550
Provider Business Practice Location Address Fax Number:
978-686-5565
Provider Enumeration Date:
08/12/2005

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: 207Y00000X , with the licence number:  30477 , 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: 208156 . This is a "MMS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64826 . This is a "AETNA/USHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 703843 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: B53047 . This is a "BS/MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0104512Y0MA01 . This is a "NH BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040007238 . This is a "MC RR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8017 . This is a "AAO/HNS" identifier . This identifiers is of the category "OTHER".
  • Identifier: B53047 . This is a "BS-HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30204079 . This is a "WELF / NH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043239435 . This is a "UNITED HC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2009226 . This is a "WELF/ MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: A35828 . This is a "MC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0013663 . This is a "NHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2009226 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36037 . This is a "FALLON" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA4456 . This is a "H/PIL" identifier . This identifiers is of the category "OTHER".




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