| |
50 Memorial Dr Suite 103 Leominster MA 01453-2238 | |
(978) 534-8607 | |
(978) 840-4670 |
Full Name | |
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Speciality | Family Medicine |
Location | 50 Memorial Dr, Leominster, Massachusetts |
Authorized Official Name and Position | Thomas J. Scornavacca (OWNER. PHYSICIAN.) |
Authorized Official Contact | 9785348607 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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50 Memorial Dr Suite 103 Leominster MA 01453-2238 Ph: (978) 534-8607 | 50 Memorial Dr Suite 103 Leominster MA 01453-2238 Ph: (978) 534-8607 |
NPI Number | 1023142668 |
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Provider Enumeration Date | 03/15/2007 |
Last Update Date | 07/31/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023142668 | NPI | - | NPPES |
155208 | Other | TUFTS | |
M17805 | Other | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 155208 (Massachusetts) | Primary |
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