Healthcare Provider Details

I. General information

NPI: 1366897985
Provider Name (Legal Business Name): ERIKA CUZZONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 05/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MAPLE ST
SPRINGFIELD MA
01105-1864
US

IV. Provider business mailing address

110 MAPLE ST
SPRINGFIELD MA
01105-1864
US

V. Phone/Fax

Practice location:
  • Phone: 413-732-7419
  • Fax: 413-781-1059
Mailing address:
  • Phone: 413-732-7419
  • Fax: 413-781-1059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: