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NPI Code Detail

MEDICARE: ELSA VELAZQUEZ-MCGUIRK MD

MEDICARE: ELSA VELAZQUEZ-MCGUIRK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ND0900XDermatopathology Physician001708NY
2207ZD0900XDermatopathology (Pathology) Physician229776MA
3207ZP0102XAnatomic Pathology & Clinical Pathology Physician229776MA

General Provider Information

NPI Number : 1043206527
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELSA VELAZQUEZ-MCGUIRK MD
Provider Business Mailing Address
First Line : 27 FRONTIER DR
Second Line :
City : WALPOLE
State : MA
Zip : 02081-5010
Country : US
Telephone Number : 917-837-8445
Fax Number :
Provider Business Practice Location Address
First Line : 15 CRAWFORD ST STE 100
Second Line :
City : NEEDHAM
State : MA
Zip : 02494-2618
Country : US
Telephone Number : 617-969-4100
Fax Number : 617-969-3393
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 06/01/2021

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