Basic Information
| Provider Information | |||||||||
| NPI: | 1144294273 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PACIFICO | ||||||||
| FirstName: | LUIGI | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 PLANTATION ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683130 | ||||||||
| FaxNumber: | 5083683133 | ||||||||
| Practice Location | |||||||||
| Address1: | 123 SUMMER ST | ||||||||
| Address2: | SUITE 290 N | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683130 | ||||||||
| FaxNumber: | 5083683133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 02/20/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 71660 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 26916 | 01 | CHILDRENS MED SECURITY | OTHER | 1061138 | 01 | FIRST HEALTH | OTHER | J16208 | 01 | BLUE SHIELD INDEMNITY | OTHER | 043058466 | 01 | HEALTHCARE VALUE MGMT | OTHER | 3142558 | 01 | MEDICAID WELFARE | OTHER | 991143 | 01 | FALLON COMMUNITY HEALTH | OTHER | 3142558 | 05 | MA | MEDICAID | 784062 | 01 | MVP HEALTH CARE | OTHER | A20386 | 01 | MEDICARE B | OTHER | J16208 | 01 | BLUE SHIELD HMO BLUE | OTHER | 26916 | 01 | HEALTHY START | OTHER | J16208 | 01 | BLUE CARE ELECT | OTHER | 2500247 | 01 | EVERCARE | OTHER | 3137201 | 01 | MEDICAID PCC | OTHER | AA2840 | 01 | HARVARD PILGRIM | OTHER | 5432660 | 01 | AETNA US HEALTHCARE | OTHER | 5818752 | 01 | CIGNA HEALTH PLAN | OTHER |