Basic Information
| Provider Information | |||||||||
| NPI: | 1437129400 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYRNE | ||||||||
| FirstName: | THOMAS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26 QUEEN ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016102473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088607706 | ||||||||
| FaxNumber: | 5088607929 | ||||||||
| Practice Location | |||||||||
| Address1: | 425 REVERE ST | ||||||||
| Address2: | |||||||||
| City: | REVERE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021514543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812861313 | ||||||||
| FaxNumber: | 7812861098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2006 | ||||||||
| LastUpdateDate: | 08/28/2015 | ||||||||
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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 | 207Q00000X | 13194 | NH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 253636 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.