Healthcare Provider Details

I. General information

NPI: 1255337036
Provider Name (Legal Business Name): ARIF MATIN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/25/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BIRNIE AVE STE 101
SPRINGFIELD MA
01107-1121
US

IV. Provider business mailing address

300 BIRNIE AVE STE 101
SPRINGFIELD MA
01107-1121
US

V. Phone/Fax

Practice location:
  • Phone: 413-736-5649
  • Fax: 413-736-5099
Mailing address:
  • Phone: 413-736-5649
  • Fax: 413-736-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21591
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number21591
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: