Healthcare Provider Details

I. General information

NPI: 1568462448
Provider Name (Legal Business Name): MARGARET A MASTRANGELO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 NEW LUDLOW RD CHICOPEE MEDICAL CENTER
CHICOPEE MA
01020-4324
US

IV. Provider business mailing address

260 NEW LUDLOW RD WESTERN MASS PHYSICIAN ASSOCIATES, INC.
CHICOPEE MA
01020-4324
US

V. Phone/Fax

Practice location:
  • Phone: 413-552-3250
  • Fax: 413-552-3255
Mailing address:
  • Phone: 413-533-3470
  • Fax: 413-533-6859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number205310
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: