Healthcare Provider Details

I. General information

NPI: 1881669901
Provider Name (Legal Business Name): PATRICK N LAFOND PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 11/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CAREW ST
SPRINGFIELD MA
01104-2377
US

IV. Provider business mailing address

9 OAK LN
WESTFIELD MA
01085-4519
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-9670
  • Fax:
Mailing address:
  • Phone: 413-562-9439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number997
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: