Basic Information
| Provider Information | |||||||||
| NPI: | 1386676872 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORQUIOLA | ||||||||
| FirstName: | ALBERT | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 WRIGHT STREET | ||||||||
| Address2: | |||||||||
| City: | PALMER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010691138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132837651 | ||||||||
| FaxNumber: | 4132845117 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 WRIGHT STREET | ||||||||
| Address2: | |||||||||
| City: | PALMER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010691138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132845276 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 02/11/2010 | ||||||||
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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 | 207L00000X | 37620 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 208D00000X | 37620 | MA | N | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 050043608 | 01 | RAILROAD MEDICARE | OTHER | 2034816 | 05 | MA | MEDICAID | 102055 | 01 | CIGNA | OTHER | H12010 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 4390337 | 01 | HEALTHSOURCE CMHC | OTHER | 52418 | 01 | FALLON COMM HEALTH PLAN | OTHER | 70992 | 01 | HARVARD PILGRIM | OTHER | 037620 | 01 | TUFTS COMM HEALTH PLAN | OTHER | 999889 | 01 | NETWORK HEALTH | OTHER | 2003058 | 01 | UNITED HEALTH CARE | OTHER |