Healthcare Provider Details

I. General information

NPI: 1518812312
Provider Name (Legal Business Name): TRACY J BENERAKIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 MAIN ST
SPRINGFIELD MA
01103-2114
US

IV. Provider business mailing address

1049 MAIN ST
SPRINGFIELD MA
01103-2114
US

V. Phone/Fax

Practice location:
  • Phone: 413-739-1100
  • Fax: 413-735-1133
Mailing address:
  • Phone: 413-739-1100
  • Fax: 413-735-1133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN195612
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: