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General NPI Number Information
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NPI Number | 1245206432
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Entity Type | Individual
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Provider Name | ANNETTE K BATES PA
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Gender | Female
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 819 WORCESTER ST STE 3
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City | SPRINGFIELD
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State | MA
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Zip | 01151-1056
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Country | US
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Telephone | 413-543-6820
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Fax | 413-543-7962
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Provider Business Mailing Address
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Address Line | 819 WORCESTER ST STE 3
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City | SPRINGFIELD
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State | MA
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Zip | 01151-1056
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Country | US
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Telephone | 413-543-6820
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Fax | 413-543-7962
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2045
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License Number State | MA
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