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General NPI Number Information
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NPI Number | 1881701365
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Entity Type | Individual
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Provider Name | CONRAD CALVIN LO P.A.-C.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 2 MEDICAL CENTER DR
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City | SPRINGFIELD
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State | MA
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Zip | 01107-1270
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Country | US
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Telephone | 413-794-5600
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Fax | 413-794-5242
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Provider Business Mailing Address
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Address Line | 280 CHESTNUT ST FL 2
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City | SPRINGFIELD
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State | MA
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Zip | 01199-1001
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Country | US
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Telephone | 413-794-5700
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Fax | 413-794-1629
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA6897
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085-002461
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110007542
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License Number State | VA
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