Provider Demographics
NPI:1730447095
Name:GALASSO, PAUL
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:GALASSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TAFT ST
Mailing Address - Street 2:#2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1819
Mailing Address - Country:US
Mailing Address - Phone:973-818-0266
Mailing Address - Fax:
Practice Address - Street 1:338 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-5042
Practice Address - Country:US
Practice Address - Phone:783-329-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker