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NPI Code Detail

MEDICARE: SASA PERISKIC M.D.

MEDICARE:   SASA  PERISKIC  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
1207LP2900XPain Medicine (Anesthesiology) Physician203186MA
2208VP0014XInterventional Pain Medicine Physician203186MA

General Provider Information

NPI Number : 1447253976
Entity Type Code : Individual
Provider Name (Legal Business Name) : SASA PERISKIC M.D.
Provider Business Mailing Address
First Line : 50 ROWE ST STE 100
Second Line :
City : MELROSE
State : MA
Zip : 02176-3231
Country : US
Telephone Number : 781-662-7246
Fax Number :
Provider Business Practice Location Address
First Line : 50 ROWE ST STE 100
Second Line :
City : MELROSE
State : MA
Zip : 02176-3231
Country : US
Telephone Number : 781-662-7246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2005
Last Update Date : 08/15/2023

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Directions to “ SASA PERISKIC M.D.” Practice Location

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