Healthcare Provider Details

I. General information

NPI: 1700210481
Provider Name (Legal Business Name): CD PRACTICE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 08/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WEST ST
WEST HATFIELD MA
01088-9562
US

IV. Provider business mailing address

30 LOCUST ST PO BOX 911
NORTHAMPTON MA
01060-2052
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-8200
  • Fax: 413-582-1460
Mailing address:
  • Phone: 413-582-2898
  • Fax: 413-582-2958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name: EDITH PETER
Title or Position: VP FINANCE
Credential:
Phone: 413-582-2213