Basic Information
| Provider Information | |||||||||
| NPI: | 1821014457 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLEARY | ||||||||
| FirstName: | FRANCIS | ||||||||
| MiddleName: | X | ||||||||
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| Credential: | MD,FACC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 HERRICK ST | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | BEVERLY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019155900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789278400 | ||||||||
| FaxNumber: | 9789221452 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 HERRICK ST | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | BEVERLY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019155900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789278400 | ||||||||
| FaxNumber: | 9789221452 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 01/29/2014 | ||||||||
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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 | 174400000X | 54331 | MA | N | Other Service Providers | Specialist | 207RC0000X | 54331 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 4336447 | 01 | MA | AETNA | OTHER | 060018874 | 01 | MA | RAILROAD MEDICARE | OTHER | 2500002 | 01 | MA | UNITED HEALTHCARE | OTHER | 042804155 | 01 | MA | HEALTH NET--NORTH REGION | OTHER | 6194915 | 05 | MA | MEDICAID | 054331 | 01 | MA | TUFTS PROVIDER NUMBER | OTHER | 3406 | 01 | MA | HARVARD PILGRIM | OTHER | 97140001 | 01 | MA | NETWORK HEALTH PLAN | OTHER | 042804155 | 01 | MA | CIGNA HEALTH PLAN | OTHER | 2833 | 01 | MA | FALLON HEALTH PLAN | OTHER | J04475 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER |