Healthcare Provider Details

I. General information

NPI: 1821337627
Provider Name (Legal Business Name): NEW ENGLAND ENDOCRINE AND THYROID CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CAREW ST SUITE 323
SPRINGFIELD MA
01104-2301
US

IV. Provider business mailing address

PO BOX 10417
HOLYOKE MA
01041-2017
US

V. Phone/Fax

Practice location:
  • Phone: 413-540-0150
  • Fax:
Mailing address:
  • Phone: 413-887-6103
  • Fax:

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: CANDICE DONNELLY
Title or Position: VP OF OPERATIONS
Credential:
Phone: 413-887-6103