Provider Demographics
NPI:1215948195
Name:VIRNELLI, FRANK R (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:R
Last Name:VIRNELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DIX STREET
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1870
Mailing Address - Country:US
Mailing Address - Phone:781-729-0947
Mailing Address - Fax:781-729-3569
Practice Address - Street 1:15 DIX ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1870
Practice Address - Country:US
Practice Address - Phone:781-729-0947
Practice Address - Fax:781-729-3569
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32985208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA21731OtherHARVARD PILGRIM
MAB53059OtherBCBS
MA0190179Medicaid
MA705054OtherTUFTS
MA0190179Medicaid
MA705054OtherTUFTS