Healthcare Provider Details

I. General information

NPI: 1841697687
Provider Name (Legal Business Name): ELAINE B PANITZ MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 BRUSH HILL ROAD
SHEFFIELD MA
01257
US

IV. Provider business mailing address

PO BOX 936
SHEFFIELD MA
01257-0936
US

V. Phone/Fax

Practice location:
  • Phone: 413-229-3390
  • Fax: 413-229-3391
Mailing address:
  • Phone: 413-229-3390
  • Fax: 413-229-3391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA02881900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: