Provider Demographics
NPI:1679819031
Name:TRYZELAAR, JOAN F (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:F
Last Name:TRYZELAAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:304 BROOKSBY VILLAGE DR UNIT 702
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-8590
Mailing Address - Country:US
Mailing Address - Phone:207-415-1307
Mailing Address - Fax:207-221-1526
Practice Address - Street 1:500 CUMMINGS CTR STE 1800
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-921-1210
Practice Address - Fax:978-921-1534
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2018-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME010688207QA0505X, 208G00000X
MA4066208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1679819031OtherNPI NUMBER