Provider Demographics
NPI:1992739791
Name:ROSIELLO, RICHARD A (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:ROSIELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-368-3120
Mailing Address - Fax:508-368-3121
Practice Address - Street 1:123 SUMMER STREET
Practice Address - Street 2:SUITE 390
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-368-3120
Practice Address - Fax:508-368-3121
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA59781207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
4864203OtherCIGNA HEALTH PLAN
9900250OtherFALLON COMMUNITY HEALTH P
J07963OtherBLUE SHIELD HMO BLUE
27207OtherCHILDRENS MEDICAL SECURIT
27207OtherHEALTHY START
5614058OtherAETNA US HEALTHCARE
784077OtherMVP HEALTH CARE
784078OtherMVP HEALTH CARE
290011567OtherRAILROAD MEDICARE
J07963OtherBLUE SHIELD INDEMNITY
042472266OtherPRIVATE HEALTHCARE SYSTEM
J07963OtherBLUE CARE ELECT
MA3046745Medicaid
042472266OtherONE HEALTH PLAN
4800063OtherEVERCARE
AA2311OtherHARVARD PILGRIM HEALTHCAR
042472266OtherHEALTHCARE VALUE MANAGEME
935071OtherFIRST HEALTH
042472266OtherONE HEALTH PLAN
J07963OtherBLUE SHIELD HMO BLUE