Healthcare Provider Details

I. General information

NPI: 1053379016
Provider Name (Legal Business Name): PIYUSH R JOHARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PARK AVE STE 5
WEST SPRINGFIELD MA
01089-3366
US

IV. Provider business mailing address

201 PARK AVE STE 5
WEST SPRINGFIELD MA
01089-3366
US

V. Phone/Fax

Practice location:
  • Phone: 413-300-3999
  • Fax: 413-315-5743
Mailing address:
  • Phone: 413-300-3999
  • Fax: 413-315-5743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number217601
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: