Healthcare Provider Details

I. General information

NPI: 1447659016
Provider Name (Legal Business Name): AMANDA GOULD FALVEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA L. GOULD PA-C

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 07/20/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 COTTAGE ST
SPRINGFIELD MA
01104-3219
US

IV. Provider business mailing address

3455 MAIN ST STE 5 NEW ENGLAND DERMATOLOGY & LASER CENTER
SPRINGFIELD MA
01107-1147
US

V. Phone/Fax

Practice location:
  • Phone: 413-750-9044
  • Fax: 413-301-6677
Mailing address:
  • Phone: 413-733-9600
  • Fax: 413-732-6534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA5094
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: