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General NPI Number Information
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NPI Number | 1114904497
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Entity Type | Individual
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Provider Name | JAY S FLEITMAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 06/22/2009
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Provider Practice Location Address
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Address Line | 90 CONZ ST
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3881
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Country | US
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Telephone | 413-586-9100
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Fax | 413-586-3379
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Provider Business Mailing Address
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Address Line | PO BOX 789
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City | LUDLOW
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State | MA
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Zip | 01056-0789
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Country | US
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Telephone | 413-509-1000
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Fax | 413-509-1003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 52983
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 52983
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License Number State | MA
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