Healthcare Provider Details

I. General information

NPI: 1093897852
Provider Name (Legal Business Name): VALLEY MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 MAIN ST SUITE 207
SPRINGFIELD MA
01107-1145
US

IV. Provider business mailing address

3640 MAIN ST SUITE 207
SPRINGFIELD MA
01107-1145
US

V. Phone/Fax

Practice location:
  • Phone: 413-739-0669
  • Fax: 413-739-0621
Mailing address:
  • Phone: 413-739-0669
  • Fax: 413-739-0621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CHERYL M SIRARD
Title or Position: OFFICE MANAGER
Credential: RN
Phone: 413-739-0669