Healthcare Provider Details

I. General information

NPI: 1902429103
Provider Name (Legal Business Name): ANNELISA PESSETTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 MIDDLESEX TPKE STE 3110
BURLINGTON MA
01803-5358
US

IV. Provider business mailing address

85 MIDDLESEX TPKE STE 3110
BURLINGTON MA
01803-5358
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-1066
  • Fax:
Mailing address:
  • Phone: 781-744-1066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number709516
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number1028274
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: