Healthcare Provider Details

I. General information

NPI: 1982677860
Provider Name (Legal Business Name): SUSAN G. RAY-LAMOND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 NORTHAMPTON ST #A
EASTHAMPTON MA
01027-1057
US

IV. Provider business mailing address

179 NORTHAMPTON ST #A
EASTHAMPTON MA
01027-1057
US

V. Phone/Fax

Practice location:
  • Phone: 413-529-0600
  • Fax: 413-529-1919
Mailing address:
  • Phone: 413-529-0600
  • Fax: 413-529-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number72019
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: