MEDICARE: PEDRO M SANZ-ALTAMIRA M.D.

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
1	207RH0003X	Hematology & Oncology Physician	80463	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0021712	OTHER	MA	AETNA US HEALTH
2	B20804901	OTHER	MA	CIGNA
3	080463	OTHER	MA	TUFTS HEALTH CARE
4	14360	OTHER	MA	HARVARD PILGRIM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	J19263	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1326021429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO M SANZ-ALTAMIRA M.D.

Provider Business Mailing Address
First Line	:	10 WILLARD ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-1281
Country	:	US
Telephone Number	:	617-479-1458
Fax Number	:	617-479-3500

Provider Business Practice Location Address
First Line	:	25 MARSTON ST
Second Line	:	SUITE #301
City	:	LAWRENCE
State	:	MA
Zip	:	01841-2310
Country	:	US
Telephone Number	:	978-946-8230
Fax Number	:	978-946-8226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	01/21/2014

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