Healthcare Provider Details

I. General information

NPI: 1427605278
Provider Name (Legal Business Name): DR. LIANA ZUCCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BETH ISRAEL DEACONESS MEDICAL CENTRE, DEPT ANESTHESIA 330 BROOKLINE AVE, YA-02Q02
BOSTON MA
02215
US

IV. Provider business mailing address

330 BROOKLINE AVE
BOSTON MA
02215-5491
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-5048
  • Fax:
Mailing address:
  • Phone: 617-667-3112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1014481
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number280784
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: