Healthcare Provider Details

I. General information

NPI: 1316346885
Provider Name (Legal Business Name): HILLARY REALE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 FENN ST ADMINISTRATIVE OFFICES
PITTSFIELD MA
01201
US

IV. Provider business mailing address

77 MILL STREET ICC
WESTFIELD MA
01085
US

V. Phone/Fax

Practice location:
  • Phone: 413-629-1251
  • Fax: 413-448-2198
Mailing address:
  • Phone: 413-572-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: