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NPI Code Detail

MEDICARE: VASCULAR LABORATORY OF WESTERN NEW ENGLAND

MEDICARE: VASCULAR LABORATORY OF WESTERN NEW ENGLAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1293D00000XPhysiological Laboratory

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922080555
Entity Type Code : Organization
Provider Name (Legal Business Name) : VASCULAR LABORATORY OF WESTERN NEW ENGLAND
Provider Business Mailing Address
First Line : 3500 MAIN ST
Second Line : SUITE 202
City : SPRINGFIELD
State : MA
Zip : 01107-1110
Country : US
Telephone Number : 413-784-0900
Fax Number : 413-781-5035
Provider Business Practice Location Address
First Line : 3500 MAIN ST
Second Line : SUITE 202
City : SPRINGFIELD
State : MA
Zip : 01107-1110
Country : US
Telephone Number : 413-784-0900
Fax Number : 413-781-5035
Authorized Official
Title or Position : MANAGING PARTNER
Name : DR. JEFFREY LAWRENCE KAUFMAN
Credential : M.D.
Telephone Number : 413-784-0900
Provider Enumeration Date : 11/18/2005
Last Update Date : 08/22/2020

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Directions to “VASCULAR LABORATORY OF WESTERN NEW ENGLAND ” Practice Location

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