Provider Demographics
NPI:1962596890
Name:WASCO, JAMES E (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:WASCO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:LAHEY CLINIC
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8085
Mailing Address - Fax:781-744-5215
Practice Address - Street 1:1 ESSEX CENTER DR
Practice Address - Street 2:EMERGENCY DEPARTMENT, LAHEY CLINIC NORTHSHORE
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2901
Practice Address - Country:US
Practice Address - Phone:978-538-4600
Practice Address - Fax:978-538-4707
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-11-11
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Provider Licenses
StateLicense IDTaxonomies
MA32607207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110066153AMedicaid
MAD1425301Medicare PIN