Healthcare Provider Details

I. General information

NPI: 1891158689
Provider Name (Legal Business Name): SAMANTHA MCVAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 SOUTHAMPTON RD
WESTFIELD MA
01085-1370
US

IV. Provider business mailing address

262 NEW LUDLOW RD
CHICOPEE MA
01020-4324
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2826
  • Fax: 413-535-2829
Mailing address:
  • Phone: 413-535-4714
  • Fax: 413-535-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number282372
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: