Healthcare Provider Details

I. General information

NPI: 1760672851
Provider Name (Legal Business Name): BRACHA K GOLDSWEIG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 WASON AVENUE 1ST FL
SPRINGFIELD MA
01107-1274
US

IV. Provider business mailing address

280 CHESTNUT STREET 2ND FLOOR
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-5437
  • Fax: 413-794-0395
Mailing address:
  • Phone: 413-794-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD15475
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number269085
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: