Healthcare Provider Details

I. General information

NPI: 1275566622
Provider Name (Legal Business Name): NAYYER GHIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BEECH STREET
HOLYOKE MA
01040
US

IV. Provider business mailing address

575 BEECH STREET
HOLYOKE MA
01040
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2608
  • Fax: 413-540-5005
Mailing address:
  • Phone: 413-534-2608
  • Fax: 413-540-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number80299
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: