Healthcare Provider Details

I. General information

NPI: 1821171059
Provider Name (Legal Business Name): UNIVERSITY OF MASSACHUSETTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 NORTH PLEASANT ST
AMHERST MA
01003-9296
US

IV. Provider business mailing address

358 NORTH PLEASANT ST
AMHERST MA
01003-9296
US

V. Phone/Fax

Practice location:
  • Phone: 413-545-2565
  • Fax: 413-545-0803
Mailing address:
  • Phone: 413-545-2565
  • Fax: 413-545-0803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA A MERCAITIS
Title or Position: INTERIM CLINIC DIRECTOR
Credential: PHD CCCSLP
Phone: 413-545-2007