Healthcare Provider Details

I. General information

NPI: 1063751923
Provider Name (Legal Business Name): SELENA M MACHIA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SELENA MARIE ZAMORA PA-C

II. Dates (important events)

Enumeration Date: 02/12/2013
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BIRNIE AVE STE 201
SPRINGFIELD MA
01107-1121
US

IV. Provider business mailing address

300 BIRNIE AVE STE 201
SPRINGFIELD MA
01107-1121
US

V. Phone/Fax

Practice location:
  • Phone: 413-785-4666
  • Fax: 413-846-4756
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9113486
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number3058
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA4624
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: