MEDICARE: DR. DEBORAH BUCCINO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	151501	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	151501	OTHER	TUFTS HEALTH PLAN
2	P722165	OTHER	OXFORD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	26599	OTHER	MVP
5	073130	OTHER	CTCARE
6	10029271	OTHER	CDPHP
7	18701	OTHER	HEALTH NEW ENGLAND
8	J17043	OTHER	BCBS OF MASS
9	000000020949	OTHER	BMC HEALTHNET
10	005026765	OTHER	AETNA
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	1385731	OTHER	UNITED HEALTH
13	G41354	OTHER	HARVARD PILGRIM HEALTH PL
14	102755	OTHER	CIGNA
15	28097	OTHER	CHILDRENS MEDICAL SEC
16	MA4407	OTHER	HEALTHNET OF THE NE INC

General Provider Information

NPI Number	:	1568455913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH BUCCINO MD

Provider Business Mailing Address
First Line	:	100 MAPLE AVE STE 1
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1965
Country	:	US
Telephone Number	:	413-528-4047
Fax Number	:	413-528-3407

Provider Business Practice Location Address
First Line	:	100 MAPLE AVE STE 1
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1965
Country	:	US
Telephone Number	:	413-528-4047
Fax Number	:	413-528-3407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	08/27/2007

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