Healthcare Provider Details

I. General information

NPI: 1396766424
Provider Name (Legal Business Name): ENDOCRINE ASSOCIATES OF WESTERN MASS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL CENTER DR STE. 210
SPRINGFIELD MA
01107-1270
US

IV. Provider business mailing address

2 MEDICAL CENTER DR STE. 210
SPRINGFIELD MA
01107-1270
US

V. Phone/Fax

Practice location:
  • Phone: 413-734-4661
  • Fax: 413-737-1930
Mailing address:
  • Phone: 413-734-4661
  • Fax: 413-737-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BARRY Z IZENSTEIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 413-734-4661