MEDICARE: DOMINIC A ZAZZARINO 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	208600000X	Surgery Physician	36543	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	713213	OTHER	MA	TUFTS HEALTH PLAN
2	8021	OTHER	MA	HARVARD PILGRIM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	J20059	OTHER	MA	BCBSMA

General Provider Information

NPI Number	:	1689649816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIC A ZAZZARINO M.D.

Provider Business Mailing Address
First Line	:	10 CORDAGE PARK CIR
Second Line	:	SUITE 227
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-7318
Country	:	US
Telephone Number	:	508-746-1259
Fax Number	:	508-747-6685

Provider Business Practice Location Address
First Line	:	10 CORDAGE PARK CIR
Second Line	:	SUITE 227
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-7318
Country	:	US
Telephone Number	:	508-746-1259
Fax Number	:	508-747-6685

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/08/2007

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