1477506772 NPI number — DR. GIULIO ISIDORO CAVALLI M.D.

Table of content: DR. GIULIO ISIDORO CAVALLI M.D. (NPI 1477506772)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477506772 NPI number — DR. GIULIO ISIDORO CAVALLI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAVALLI
Provider First Name:
GIULIO
Provider Middle Name:
ISIDORO
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:
1477506772
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
195 SOUTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01201-6831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-443-6116
Provider Business Mailing Address Fax Number:
413-443-9099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
195 SOUTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01201-6831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-443-6116
Provider Business Practice Location Address Fax Number:
413-443-9099
Provider Enumeration Date:
05/18/2006

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: 207Y00000X , with the licence number:  154132 , 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: 000000020944 . This is a "BMC HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 154132 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: G22020 . This is a "HARVARD PILGRIM HEALTH PL" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 040017945 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04885 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8009601 . This is a "CIGNA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0017609 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J18395 . This is a "BC/BS MASSACHUSETTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 20605 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3171469 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com