Healthcare Provider Details

I. General information

NPI: 1639285133
Provider Name (Legal Business Name): STEPHEN S BERZANSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 CENTRAL ST
GEORGETOWN MA
01833-2425
US

IV. Provider business mailing address

65 CENTRAL ST
GEORGETOWN MA
01833-2425
US

V. Phone/Fax

Practice location:
  • Phone: 978-352-7780
  • Fax: 978-352-4542
Mailing address:
  • Phone: 978-352-7780
  • Fax: 978-352-4542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number73237
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number73237
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: