Healthcare Provider Details

I. General information

NPI: 1568439818
Provider Name (Legal Business Name): HOLYOKE PEDIATRIC ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 LOWER WESTFIELD RD STE1
HOLYOKE MA
01040-2767
US

IV. Provider business mailing address

150 LOWER WESTFIELD RD STE1
HOLYOKE MA
01040-2767
US

V. Phone/Fax

Practice location:
  • Phone: 413-536-2393
  • Fax: 413-536-1087
Mailing address:
  • Phone: 413-536-2393
  • Fax: 413-536-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBRA DUQUETTE
Title or Position: CREDENTIALING
Credential:
Phone: 413-313-0236