=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356389985
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STANLEY D. STRZEMPKO MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2006
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 57 UNION STREET STE 101
-----------------------------------------------------
City | WESTFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01085-4224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-831-7894
-----------------------------------------------------
Fax | 413-831-7895
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 280 CHESTNUT STREET 2ND FLOOR
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01199-1001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-794-5700
-----------------------------------------------------
Fax | 413-794-1629
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 79012
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------