Healthcare Provider Details

I. General information

NPI: 1881913002
Provider Name (Legal Business Name): STEVEN J COVICI MD FACS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LIBERTY ST SUITE 308
SPRINGFIELD MA
01103-1114
US

IV. Provider business mailing address

125 LIBERTY ST SUITE 308
SPRINGFIELD MA
01103-1114
US

V. Phone/Fax

Practice location:
  • Phone: 413-737-7300
  • Fax: 413-737-7377
Mailing address:
  • Phone: 413-737-7300
  • Fax: 413-737-7377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN J COVICI
Title or Position: PRESIDENT
Credential: MD
Phone: 413-737-7300