Healthcare Provider Details

I. General information

NPI: 1891721460
Provider Name (Legal Business Name): HOWARD WARREN RAYMOND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W SILVER ST NOBLE HOSPITAL
WESTFIELD MA
01085-3628
US

IV. Provider business mailing address

50 LINDOR HTS
HOLYOKE MA
01040-1847
US

V. Phone/Fax

Practice location:
  • Phone: 413-572-5055
  • Fax:
Mailing address:
  • Phone: 413-532-3455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number38313
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: