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General NPI Number Information
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NPI Number | 1518153071
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Entity Type | Organization
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Legal Business Name | PATRICK V MARASCO JR, MD, PC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 43 HIGH ST SUITE 110B
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-2646
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Country | US
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Telephone | 978-687-3242
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Fax | 978-208-8414
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Provider Business Mailing Address
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Address Line | 43 HIGH ST SUITE 110B
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-2646
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Country | US
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Telephone | 978-687-3242
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Fax | 978-208-8414
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Authorized Official
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Title or Position | PLASTIC SURGEON/OWNER
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Name | PATRICK V MARASCO JR.
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Credential | MD
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Telephone | 978-687-3242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 56106
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License Number State | MA
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