Healthcare Provider Details

I. General information

NPI: 1336938422
Provider Name (Legal Business Name): MATTHEW LAAMANEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

421 N MAIN ST
LEEDS MA
01053-9764
US

IV. Provider business mailing address

146 CHURCH ST
LUDLOW MA
01056-1305
US

V. Phone/Fax

Practice location:
  • Phone: 413-210-6575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN2295220
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2295220
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: