Healthcare Provider Details

I. General information

NPI: 1881743029
Provider Name (Legal Business Name): JAMES ROBATOR JR. PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CAREW ST STE 323
SPRINGFIELD MA
01104
US

IV. Provider business mailing address

300 STAFFORD ST SUITE 303
SPRINGFIELD MA
01104-3581
US

V. Phone/Fax

Practice location:
  • Phone: 413-732-9600
  • Fax: 413-732-9621
Mailing address:
  • Phone: 413-732-9600
  • Fax: 413-732-9621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number786
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: