Provider Demographics
NPI:1730153891
Name:MESONERO, CLARA (MD)
Entity type:Individual
Prefix:DR
First Name:CLARA
Middle Name:
Last Name:MESONERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:27 PARK ST
Mailing Address - Street 2:CAPE COD HOSPITAL, DEPT. OF PATHOLOGY
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5230
Mailing Address - Country:US
Mailing Address - Phone:508-862-5267
Mailing Address - Fax:508-771-7786
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:CAPE COD HOSPITAL, DEPT. OF PATHOLOGY
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5230
Practice Address - Country:US
Practice Address - Phone:508-862-5267
Practice Address - Fax:508-771-7786
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA156860207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA600372OtherHARVARD PILGRIM
MA3187616Medicaid
MA220025126OtherRAILROAD MEDICARE
MA792926OtherTUFTS HEALTH PLAN
MAJ19531OtherBCBS MA
MA792926OtherTUFTS HEALTH PLAN