Healthcare Provider Details

I. General information

NPI: 1912966466
Provider Name (Legal Business Name): ABOU-KACEM SEKKAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W SILVER ST
WESTFIELD MA
01085-3628
US

IV. Provider business mailing address

280 CHESTNUT STREET 2ND FL
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-572-6010
  • Fax: 413-572-6009
Mailing address:
  • Phone: 417-794-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number58596
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: