Healthcare Provider Details

I. General information

NPI: 1346927464
Provider Name (Legal Business Name): SYED IMRAN RAZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 CHESTNUT ST
SPRINGFIELD MA
01199-1000
US

IV. Provider business mailing address

280 CHESTNUT ST UHC-9C (GME OFFICE)
SPRINGFIELD MA
01199-1000
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-3245
  • Fax: 413-794-8428
Mailing address:
  • Phone: 413-794-3245
  • Fax: 413-794-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: