Healthcare Provider Details

I. General information

NPI: 1356021554
Provider Name (Legal Business Name): JOEL ADAM LECONTE FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BEECH ST
HOLYOKE MA
01040-2223
US

IV. Provider business mailing address

2 MEDICAL CENTER DR
SPRINGFIELD MA
01107-1270
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2500
  • Fax:
Mailing address:
  • Phone: 413-748-7095
  • Fax: 413-732-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2335552
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: