Healthcare Provider Details

I. General information

NPI: 1780669689
Provider Name (Legal Business Name): JGS ADMINISTRATIVE SERVICES INCORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 CONVERSE ST
LONGMEADOW MA
01106-1719
US

IV. Provider business mailing address

PO BOX 789
LUDLOW MA
01056-0789
US

V. Phone/Fax

Practice location:
  • Phone: 413-567-3949
  • Fax: 413-567-0175
Mailing address:
  • Phone: 413-509-1000
  • Fax: 413-509-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ALAN ROSENFELD
Title or Position: CEO
Credential:
Phone: 413-567-3939