CHRISTOPHER L DEFAZIO (NPI# 1396711602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396711602 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER L DEFAZIO |
| Credential | MD |
| Practice Address |
585 Lebanon St Melrose MA 02176 |
| Mailing Address |
114 Harris Ave Needham MA 02492 |
| Practice Telephone | 7819793635 |
| Practice Fax Number | 7819793018 |
| Mailing Telephone | 7814441536 |
| Mailing Fax Number | 7819793018 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2008-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 58772 | MA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 58772 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 3042596 | 05 | |
| BCBS | J07968 | 01 | |
| TUFTS | 058772 | 01 | |
| HARVARD PILGRIM | 665716 | 01 |
| Street Address |
585 LEBANON ST |
| City | MELROSE |
| State | MA |
| Zip Code | 02176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316928146 | Della M Barbato | Social Worker | 585 Lebanon St, Melrose Wakefield Hospital Psych, Melrose, MA 02176-3225 | 2005-11-09 |
| 1699392324 | Jacqueline Jean-piere | Nurse Practitioner | 585 Lebanon St, Melrose, MA 02176-3225 | 2020-06-29 |
| 1942827639 | Franca Nkiru Egbunike-omoruyi | Student in an Organized Health Care Education/Training Program | 585 Lebanon St, Melrose, MA 02176-3225 | 2020-06-29 |
| 1114555398 | Mw Radiology-cra LLC | Radiology | 585 Lebanon St, Melrose, MA 02176-3225 | 2020-04-01 |
| 1992344519 | Vanja Calantropo | Nurse Practitioner | 585 Lebanon St, Melrose, MA 02176-3225 | 2019-12-30 |
| 1538705736 | Kaitlyn Laidley | Registered Nurse | 585 Lebanon St, Melrose, MA 02176-3225 | 2019-11-22 |
| 1225672942 | Katelynne Kelley | Registered Nurse | 585 Lebanon St, Melrose, MA 02176-3298 | 2019-11-06 |
| 1275174054 | Bridget Valerie Murphy | Physician Assistant | 585 Lebanon St, Melrose, MA 02176-3298 | 2019-10-03 |
| 1962053926 | Neil Denis Mccarthy | Physician Assistant | 585 Lebanon St, Melrose, MA 02176-3298 | 2019-09-21 |
| 1306493705 | Paige Marie Maggiore | Pharmacist | 585 Lebanon St, Melrose, MA 02176-3225 | 2019-08-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384826 | Edrine Astremont | Registered Nurse | 414 Malden, Massachusetts, NY 02176 | 2020-07-23 |
| 1194203919 | Caroline Bregman | Social Worker | 12 Howard St, Melrose, MA 02176 | 2018-08-02 |
| 1386167682 | Carmen Alicia Fernandez | Community/Behavioral Health | 24 Lynde St, Melrose, MA 02176 | 2017-07-19 |
| 1518316116 | Sheila Kelley | Physical Therapist | 15 Green Street, Melrose, MA 02176 | 2016-06-06 |
| 1083049712 | Randi A Brown | Counselor | 610 A Main Street, Melrose, MA 02176 | 2013-09-12 |
| 1306121488 | Frank Anthony Pennacchio | Pharmacist | 17 Coolidge Road, Melrose, MA 02176 | 2011-10-20 |
| 1245401751 | Meaghan Rudolph | Registered Nurse | 11 Stratford Rd, Melrose, MA 02176 | 2008-03-13 |
| 1104039726 | Judy E Bushee | Custodial Care Facility | The Toole Nursing Home, 92 Franklin Street, Melrose, MA 02176 | 2007-05-08 |
| 1811012776 | Mark Joseph Gianatassio | Dentist | 820 Lynn Fells, Melrose, MA 02176 | 2007-03-20 |
| 1154452993 | City of Melrose | Local Education Agency (LEA) | 360 Lynn Fells Parkway, Melrose, MA 02176 | 2007-03-07 |
| Find all providers in zip 02176 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295154920 | Ariel Leroy | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2014-04-09 |
| 1447337522 | Lawrence Whiting | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-11-01 |
| 1922020353 | Shannon Bottari | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-07-24 |
| 1588683494 | John Nadolny | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-07-19 |
| 1659311751 | Manu Sondhi | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-06-07 |
| 1891733218 | Sonia R.u. Beauvais | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-06-04 |
| 1992743744 | Gary Kleeman | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-06-03 |
| 1093752214 | Thomas L Michelman | Emergency Medicine | 585 Lebanon St, Whidden Memorial Hosp, Melrose, MA 02176 | 2006-05-31 |
| 1508824004 | Garett Burke | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-05-03 |
| 1275594400 | Steven Sbardella | Emergency Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2006-03-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.