Libertino, John A

Libertino, John A is an individual health care provider with primary practice located at 41 Mall Rd , Burlington MA 01805-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Libertino, John A can be contacted via phone (781) 744-8000.

Contact Information

Primary practice address
41 Mall Rd Burlington MA 01805-0001
Fax: (781) 744-5429
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 32219 Massachusetts

Profile Details

NPI number 1043367097
LBN Legal business name Libertino, John A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jan 18th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043367097 NPPES
Massachusetts MEDICAID 6166768

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