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1306914601 NPI number — ELM STREET ADULT MEDICINE, P.C.

NPI Number: 1306914601
Health Care Provider/Practitioner: ELM STREET ADULT MEDICINE, P.C.

Information about “1306914601” NPI (ELM STREET ADULT MEDICINE, P.C.) exists in 1306914601 in HTML format HTML  |  1306914601 in plain Text format TXT  |  1306914601 in PDF (Portable Document Format) PDF  |  1306914601 in an XML format XML  formats.

NPI Number : 1306914601 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306914601",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ELM STREET ADULT MEDICINE, P.C.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "264 ELM ST",
    "SecondLineMailingAddress": "SUITES 10 & 12",
    "MailingAddressCityName": "NORTHAMPTON",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01060-2857",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "413-586-1100",
    "MailingAddressFaxNumber": "413-584-7062",
    "FirstLinePracticeLocationAddress": "264 ELM ST",
    "SecondLinePracticeLocationAddress": "SUITES 10 & 12",
    "PracticeLocationAddressCityName": "NORTHAMPTON",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01060-2857",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "413-586-1100",
    "PracticeLocationAddressFaxNumber": "413-584-7062",
    "EnumerationDate": "12/04/2006",
    "LastUpdateDate": "11/20/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DEAN",
    "AuthorizedOfficialFirstName": "EDWARD",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "MANAGING PARTNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "413-586-1100",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207R00000X",
        "TaxonomyName": "Internal Medicine Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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