Healthcare Provider Details

I. General information

NPI: 1699750711
Provider Name (Legal Business Name): RUTH ALEXANDRA POTEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 LIBERTY ST
SPRINGFIELD MA
01104-3779
US

IV. Provider business mailing address

417 LIBERTY ST
SPRINGFIELD MA
01104-3736
US

V. Phone/Fax

Practice location:
  • Phone: 413-272-1333
  • Fax: 413-858-2617
Mailing address:
  • Phone: 413-272-1333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209085
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: