Basic Information
| Provider Information | |||||||||
| NPI: | 1740299668 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAMIANI | ||||||||
| FirstName: | ALDO | ||||||||
| MiddleName: | LUCIANO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 ESSEX CENTER DR | ||||||||
| Address2: | |||||||||
| City: | PEABODY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019602901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817448000 | ||||||||
| FaxNumber: | 7817444711 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 ESSEX CENTER DR | ||||||||
| Address2: | |||||||||
| City: | PEABODY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019602901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817448000 | ||||||||
| FaxNumber: | 7817444711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 02/05/2016 | ||||||||
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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 | 207R00000X | 234461 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | AA109256 | 01 | MA | HPHC | OTHER | J42598 | 01 | MA | BCBS | OTHER | 0043844 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | 1740299668 | 01 | MA | PHCS | OTHER | 1740299668 | 01 | MA | ANTHEM | OTHER | 1740299668 | 01 | MA | FALLON COMMUNITY HEALTH PLAN | OTHER | 1740299668 | 01 | MA | AETNA | OTHER | 1740299668 | 01 | MA | BOSTON MEDICAL CENTER HEALTH PLAN | OTHER | 1087864 | 01 | MA | CIGNA | OTHER | 110078580A | 05 | MA | MEDICAID | 1740299668 | 01 | MA | UNITED HEALTHCARE | OTHER | 30207458 | 05 | NH | MEDICAID | 95569201 | 01 | MA | NETWORK HEALTH | OTHER |