Healthcare Provider Details

I. General information

NPI: 1588659858
Provider Name (Legal Business Name): STEPHEN J GALIZIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 ANDOVER ST STE 195
NORTH ANDOVER MA
01845-5068
US

IV. Provider business mailing address

451 ANDOVER ST STE 195
NORTH ANDOVER MA
01845-5068
US

V. Phone/Fax

Practice location:
  • Phone: 978-681-4700
  • Fax: 978-681-6663
Mailing address:
  • Phone: 978-681-4700
  • Fax: 978-681-6663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number206857
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: