Healthcare Provider Details

I. General information

NPI: 1497327332
Provider Name (Legal Business Name): ROBERT ABRAM OLBERG PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DENSLOW RD
EAST LONGMEADOW MA
01028-3104
US

IV. Provider business mailing address

1574 MEMORIAL AVE
WEST SPRINGFIELD MA
01089-3548
US

V. Phone/Fax

Practice location:
  • Phone: 413-565-1501
  • Fax: 413-565-1497
Mailing address:
  • Phone: 413-355-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA8266
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: