Healthcare Provider Details

I. General information

NPI: 1417586611
Provider Name (Legal Business Name): TUSHAAR VISHAL SHRIMANKER MD, MRCP(LON)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 DWIGHT RD STE 204
LONGMEADOW MA
01106-1765
US

IV. Provider business mailing address

280 CHESTNUT ST FL 2
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-4555
  • Fax: 413-794-5757
Mailing address:
  • Phone: 413-794-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number73030
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number1025111
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: