Healthcare Provider Details

I. General information

NPI: 1043506926
Provider Name (Legal Business Name): THOMAS PAUL MACARI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 SALEM ST BLDG 3 SUITE 3
LYNNFIELD MA
01940-2673
US

IV. Provider business mailing address

40 SALEM ST BLDG 3 SUITE 3
LYNNFIELD MA
01940-2673
US

V. Phone/Fax

Practice location:
  • Phone: 781-245-0843
  • Fax: 781-245-0849
Mailing address:
  • Phone: 781-245-0843
  • Fax: 781-245-0849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number249682
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: