=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568462448
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET A MASTRANGELO FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2005
-----------------------------------------------------
Last Update Date | 10/31/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 262 NEW LUDLOW RD CHICOPEE MEDICAL CENTER
-----------------------------------------------------
City | CHICOPEE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01020-4324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-552-3250
-----------------------------------------------------
Fax | 413-552-3255
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 260 NEW LUDLOW RD WESTERN MASS PHYSICIAN ASSOCIATES, INC.
-----------------------------------------------------
City | CHICOPEE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01020-4324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-533-3470
-----------------------------------------------------
Fax | 413-533-6859
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 205310
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------