Healthcare Provider Details
I. General information
NPI: 1871512814
Provider Name (Legal Business Name): COOLEY DICKINSON HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 LOCUST ST
NORTHAMPTON MA
01060-2052
US
IV. Provider business mailing address
30 LOCUST ST P.O. BOX 5001
NORTHAMPTON MA
01060-2052
US
V. Phone/Fax
- Phone: 413-582-2000
- Fax: 413-582-2981
- Phone: 413-582-2000
- Fax: 413-582-2680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | 2155 |
| License Number State | MA |
VIII. Authorized Official
Name:
LAURIE
LAMOUREUX
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 413-582-2000