MEDICARE: JOSEPH P CARROZZA JR. M.D.

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	207R00000X	Internal Medicine Physician	58769	MA
2	207RC0000X	Cardiovascular Disease Physician	58769	MA
3	207RI0011X	Interventional Cardiology Physician	58769	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639104714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH P CARROZZA JR. M.D.

Provider Business Mailing Address
First Line	:	960 MASSACHUSETTS AVE
Second Line	:	FL 2
City	:	BOSTON
State	:	MA
Zip	:	02118-2690
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	736 CAMBRIDGE ST, 4TH FL
Second Line	:	CARDIOVASCULAR MEDICINE SUITE, 4TH FL MARGARET'S
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2907
Country	:	US
Telephone Number	:	617-562-7690
Fax Number	:	617-562-7699

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	03/16/2026

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