Healthcare Provider Details

I. General information

NPI: 1013255124
Provider Name (Legal Business Name): CD PRACTICE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 CARLON DR STE C
NORTHAMPTON MA
01060-2377
US

IV. Provider business mailing address

30 LOCUST STREET CD PRACTICE ASSOCIATES, INC.
NORTHAMPTON MA
01060-2052
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-5384
  • Fax: 413-585-0018
Mailing address:
  • Phone: 413-582-2898
  • Fax: 413-582-2958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number55161
License Number StateMA

VIII. Authorized Official

Name: DAWN KOLOZYC
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 413-582-2898