Healthcare Provider Details

I. General information

NPI: 1043209323
Provider Name (Legal Business Name): ROBERT F CIPOLLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 LINDALL ST
DANVERS MA
01923-2121
US

IV. Provider business mailing address

75 LINDALL ST
DANVERS MA
01923-2121
US

V. Phone/Fax

Practice location:
  • Phone: 978-646-7088
  • Fax: 978-777-1462
Mailing address:
  • Phone: 978-646-7088
  • Fax: 978-777-1462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number74349
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: