Provider Demographics
NPI:1427138130
Name:PISICK, BARRY M (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:M
Last Name:PISICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:565 TURNPIKE STREET
Mailing Address - Street 2:SUITE 85
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-689-2247
Mailing Address - Fax:978-689-7305
Practice Address - Street 1:565 TURNPIKE STREET
Practice Address - Street 2:SUITE 85
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-689-2247
Practice Address - Fax:978-689-7305
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46901207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E56015OtherBCBS
MA0173207Medicaid
E56015OtherBCBS
A55140Medicare UPIN