Healthcare Provider Details

I. General information

NPI: 1295714657
Provider Name (Legal Business Name): CATHERINE M HEGARTY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 MAIN STREET
SPRINGFIELD MA
01104
US

IV. Provider business mailing address

2150 MAIN STREET
SPRINGFIELD MA
01104
US

V. Phone/Fax

Practice location:
  • Phone: 413-739-5676
  • Fax: 413-739-2278
Mailing address:
  • Phone: 413-739-5676
  • Fax: 413-739-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number160277
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number047014
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: