Healthcare Provider Details

I. General information

NPI: 1588457568
Provider Name (Legal Business Name): WESTERN MASS PHYSICIAN ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HOSPITAL DR
HOLYOKE MA
01040-6643
US

IV. Provider business mailing address

15 HOSPITAL DR
HOLYOKE MA
01040-6644
US

V. Phone/Fax

Practice location:
  • Phone: 413-539-6830
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEAN VITARISI
Title or Position: TREASURER & CFO
Credential:
Phone: 413-534-2567