Basic Information
| Provider Information | |||||||||
| NPI: | 1952521999 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ESSEX CARDIOLOGY ASSOCIATES, INC | ||||||||
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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: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | CLEARY | ||||||||
| AuthorizedOfficialFirstName: | FRANCIS | ||||||||
| AuthorizedOfficialMiddleName: | X | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9789278400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 0008246 | 01 | MA | NEIGHBORHOOD HEALTH | OTHER | 0063094 | 01 | MA | AETNA | OTHER | 661 | 01 | MA | FALLON | OTHER | 600476 | 01 | MA | TUFTS | OTHER | 9745483 | 05 | MA | MEDICAID | M14172 | 01 | MA | BLUE CROSS | OTHER |