Healthcare Provider Details

I. General information

NPI: 1871794867
Provider Name (Legal Business Name): SHERRI KUCHINSKAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WEST ST
WEST HATFIELD MA
01088-9515
US

IV. Provider business mailing address

4 WEST ST
WEST HATFIELD MA
01088-9515
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-8200
  • Fax:
Mailing address:
  • Phone: 413-586-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number036-114138
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: