Healthcare Provider Details

I. General information

NPI: 1497233977
Provider Name (Legal Business Name): LAUREN GORSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 NORTHAMPTON ST VALLEY MEDICAL GROUP, PC-EASTHAMPTON HEALTH CENTER
EASTHAMPTON MA
01027-1046
US

IV. Provider business mailing address

238 NORTHAMPTON ST VALLEY MEDICAL GROUP, PC-EASTHAMPTON HEALTH CENTER
EASTHAMPTON MA
01027-1046
US

V. Phone/Fax

Practice location:
  • Phone: 413-527-9300
  • Fax: 866-644-0870
Mailing address:
  • Phone: 413-527-9300
  • Fax: 866-644-0870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA7256
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: