Healthcare Provider Details

I. General information

NPI: 1437270055
Provider Name (Legal Business Name): HOLYOKE RADIOLOGISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BEECH ST
HOLYOKE MA
01040-2223
US

IV. Provider business mailing address

291 MOODY ST
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2523
  • Fax:
Mailing address:
  • Phone: 413-589-0195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRINAL S MALI
Title or Position: CHIEF
Credential: M.D.
Phone: 413-589-0195