MEDICARE: STEFANO CAZZANIGA 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
1	207R00000X	Internal Medicine Physician	MD08649	RI
2	207R00000X	Internal Medicine Physician	Q5363	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110098873	OTHER	RI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881631596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANO CAZZANIGA MD

Provider Business Mailing Address
First Line	:	902 W RANDOL MILL RD STE 150
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2581
Country	:	US
Telephone Number	:	817-417-9334
Fax Number	:	817-417-9339

Provider Business Practice Location Address
First Line	:	902 W RANDOL MILL RD STE 150
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2581
Country	:	US
Telephone Number	:	817-417-9334
Fax Number	:	817-417-9339

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	10/04/2021

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Directions to “ STEFANO CAZZANIGA MD” Practice Location

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