Cannistraro, Paul A
Cannistraro, Paul A is an sole proprietor health care provider with primary practice located at 12 Arrow St Ste 210 , Cambridge MA 02138-5105. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Cannistraro, Paul A can be contacted via phone (617) 460-1053.Contact Information
Primary practice address
12 Arrow St Ste 210
Cambridge MA 02138-5105
Phone: (617) 460-1053
Fax: (617) 848-9485
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 215892 | Massachusetts |
Profile Details
| NPI number | 1639165988 |
|---|---|
| LBN Legal business name | Cannistraro, Paul A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2005 |
| Last updated | Nov 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639165988 | NPPES |
| Massachusetts | MEDICAID | 2042291 | |
| Massachusetts | Other | 469409 | |
| Massachusetts | Other | J27378 |
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