MEDICARE: MARAGAL MEDICAL PC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1427559962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARAGAL MEDICAL PC

Provider Business Mailing Address
First Line	:	54 WILLIAMS ST
Second Line	:
City	:	LEOMINSTER
State	:	MA
Zip	:	01453-3276
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 WILLIAMS ST
Second Line	:
City	:	LEOMINSTER
State	:	MA
Zip	:	01453-3276
Country	:	US
Telephone Number	:	978-537-0555
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL A MARCIELLO
Credential	:	MD
Telephone Number	:	781-308-1435

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	02/21/2018

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