Provider Demographics
NPI:1659498517
Name:ANDOVER UROLOGY ASSOCIATES P.C.
Entity type:Organization
Organization Name:ANDOVER UROLOGY ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPPALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:978-475-4499
Mailing Address - Street 1:31 STILES RD STE 1400
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2958
Mailing Address - Country:US
Mailing Address - Phone:978-475-4499
Mailing Address - Fax:978-749-9585
Practice Address - Street 1:31 STILES RD STE 1400
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2958
Practice Address - Country:US
Practice Address - Phone:978-475-4499
Practice Address - Fax:978-749-9585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-24
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60267174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA30006434OtherTUFTS
NH150471OtherCIGNA
MA3199961OtherAETNA
MAM15949OtherBCBS MA
MAM15949OtherBCBS MA
MAA57166Medicare UPIN