Provider Demographics
NPI:1699757963
Name:FRICCHIONE, GREGORY LEWIS (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:LEWIS
Last Name:FRICCHIONE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:PSYCHIATRY ASSOCIATES INPATIENT CONSULT WRN 615A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-7695
Practice Address - Fax:617-726-5946
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2010-09-23
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Provider Licenses
StateLicense IDTaxonomies
MA773222084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3112144Medicaid
MA731503OtherTUFTS HEALTH PLAN
MAJ14091OtherBCBS MA
MA3112144Medicaid
MAJ14091Medicare ID - Type Unspecified