MARCIA WAITZMAN (NPI# 1639176910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639176910 |
| Entity Type | Individual |
| Full Name | MARCIA WAITZMAN |
| Credential | MD |
| Practice Address |
680 Centre St Brockton MA 02302-3308 |
| Mailing Address |
22 High Point Ln West Hartford CT 06107-1135 |
| Practice Telephone | 5089417299 |
| Mailing Telephone | 8606046998 |
| Mailing Fax Number | 8602326886 |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2019-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 25MA09212800 | NJ | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 145062-1 | NY | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | D0033764 | MD | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | G49767 | CA | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 242462 | MA | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | 031416 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1314161 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 25 Warren St, Randolph, MA 023684015 | 5089867900 | |
| 505 Bedford St, Bridgewater, MA 023243117 | 5086978666 | |
| 242 Green St, Labor and Delivery, Gardner, MA 014401336 | 8606046998 | 8602326886 |
| 680 Centre St, Brockton, MA 023023308 | 5089417299 |
| Street Address |
680 CENTRE ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02302-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196396 | Samantha Lipsky | Physician Assistant | 680 Centre St, Brockton, MA 02302-3308 | 2020-08-24 |
| 1760009328 | Mandi Ella Clegg | Social Worker | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-30 |
| 1972128643 | Matthew Hall Wilson | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-09 |
| 1679198493 | Alyssa Dicosmo | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-09 |
| 1720603566 | Tessie Allan | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1588289375 | Collin Rozanski | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1619592417 | Balaji Arun Jothishankar | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1013532845 | Angell Shi | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1386269124 | Rebecca Yanovsky | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1619592482 | Vaishali Mittal | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427513373 | Miriam Monteiro | Social Worker | 688 Plain Street, Brockton, MA 02302 | 2019-02-05 |
| 1619432523 | Shirley Elefson | Social Worker | 330 Crescent Street, Brockton, MA 02302 | 2019-02-05 |
| 1578055505 | Steigmward Desir | Specialist | 472 E Ashland St, Brockton, MA 02302 | 2018-06-05 |
| 1114417797 | Katherine Douglas Van Schaik | Student in an Organized Health Care Education/Training Program | Brockton Signature Healthcare-bidmc, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700376365 | Emmanuel Carrodeguas | Student in an Organized Health Care Education/Training Program | Brockton Hospital, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700303856 | My Care, LLC | Home Health | 307 Field Street, Brockton, MA 02302 | 2017-08-29 |
| 1982124988 | Shavon Franks | Psychologist | 30 Downey Rd, Brockton, MA 02302 | 2017-06-21 |
| 1831629286 | Kings & Queens Empowered | Religious Nonmedical Health Care Institution | 312 Carl Ave, Brockton, MA 02302 | 2017-06-18 |
| 1487193389 | Roseline Eliezer | Licensed Practical Nurse | 17 Simeon Avenue, Brockton, MA 02302 | 2017-02-13 |
| 1184008989 | Danielle Parker | Student in an Organized Health Care Education/Training Program | 23 Grinnell Rd, Brockton, MA 02302 | 2015-07-13 |
| Find all providers in zip 02302 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457417669 | James Marquardt, Md, PC. | Obstetrics & Gynecology | 47 Libby St, Brockton, MA 02302-2949 | 2006-12-29 |
| 1891723334 | Harold Michlewitz | Obstetrics & Gynecology | 650 Centre St, Brockton, MA 02302-3308 | 2006-06-30 |
| 1689637944 | Uhun Ro Lee | Obstetrics & Gynecology | 45 Pearl St, Brockton, MA 02301-2858 | 2006-04-08 |
| 1659759710 | Maryam Yeganegi | Obstetrics & Gynecology | 63 Main St, Brockton, MA 02301 | 2015-05-09 |
| 1851529499 | Sandy Cho | Obstetrics & Gynecology | 680 Centre St, Brockton Hospital, Signature Healthcare, Brockton, MA 02302-3308 | 2009-06-22 |
| 1114119732 | Anika Tene Moore | Obstetrics & Gynecology | 63 Main St, Brockton, MA 02301 | 2007-08-16 |
| 1093910788 | Gregory Wei Chiang Woo | Obstetrics & Gynecology | 680 Centre St, Brockton, MA 02302-3308 | 2007-06-20 |
| 1124149364 | Brooke J Bloom | Obstetrics & Gynecology | 650 Centre St, Brockton, MA 02302-3308 | 2007-04-03 |
| 1558427070 | Hanjani PC | Obstetrics & Gynecology | 830 Oak St, Ste 201w, Brockton, MA 02301-1168 | 2006-12-29 |
| 1255435707 | Ana Cristina Vasilescu | Obstetrics & Gynecology | 235 N Pearl St, Brockton, MA 02301-1794 | 2006-09-12 |
| Find all providers in BROCKTON | ||||
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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.