Healthcare Provider Details

I. General information

NPI: 1427280791
Provider Name (Legal Business Name): MWA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 GRANBY RD
CHICOPEE MA
01020-1568
US

IV. Provider business mailing address

1109 GRANBY RD
CHICOPEE MA
01020-1568
US

V. Phone/Fax

Practice location:
  • Phone: 413-523-0814
  • Fax: 413-523-0930
Mailing address:
  • Phone: 413-523-0814
  • Fax: 413-523-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT L LOUNSBURY
Title or Position: PRESIDENT
Credential: MD
Phone: 413-523-0810