Healthcare Provider Details

I. General information

NPI: 1194023044
Provider Name (Legal Business Name): HUNGRY HILL FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776 LIBERTY STREET HUNGRY HILL FAMILY PRACTICE
SPRINGFIELD MA
01104
US

IV. Provider business mailing address

776 LIBERTY STREET HUNGRY HILL FAMILY PRACTICE
SPRINGFIELD MA
01104
US

V. Phone/Fax

Practice location:
  • Phone: 413-273-1638
  • Fax: 413-273-1410
Mailing address:
  • Phone: 413-273-1638
  • Fax: 413-273-1410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number187756
License Number StateMA

VIII. Authorized Official

Name: MRS. JANE V HARPER
Title or Position: APRN,F.N.P.,B.C.
Credential: APRN
Phone: 413-273-1638