Healthcare Provider Details

I. General information

NPI: 1205171675
Provider Name (Legal Business Name): CD PRACTICE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 03/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 KING ST SUITE 124
NORTHAMPTON MA
01060-2335
US

IV. Provider business mailing address

30 LOCUST ST
NORTHAMPTON MA
01060-2052
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-2171
  • Fax: 413-584-2792
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 Number
License Number State

VIII. Authorized Official

Name: DAWN KOLOSZYC
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 413-582-2416