Healthcare Provider Details

I. General information

NPI: 1164763397
Provider Name (Legal Business Name): ALESKA PELAEZ ACOSTA MD PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 CHAPIN TER
SPRINGFIELD MA
01107-1706
US

IV. Provider business mailing address

192 LATHROP ST
SOUTH HADLEY MA
01075-1738
US

V. Phone/Fax

Practice location:
  • Phone: 413-733-6595
  • Fax: 413-733-4544
Mailing address:
  • Phone: 413-322-3097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ALESKA PELAGIA PELAEZ ACOSTA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 413-356-0508