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General NPI Number Information
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NPI Number | 1942605373
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Entity Type | Organization
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Legal Business Name | MASS GENERAL BRIGHAM MEDICAL GROUP WESTERN MASSACHUSETTS INC
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 22 ATWOOD DR SUITE 205
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City | NORTHAMPTON
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State | MA
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Zip | 01060-4272
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Country | US
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Telephone | 413-582-2175
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Fax | 413-923-9322
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Provider Business Mailing Address
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Address Line | 399 REVOLUTION DR
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City | SOMERVILLE
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State | MA
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Zip | 02145-1484
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & COO
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Name | LINDSAY GAINER
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Credential |
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Telephone | 857-282-3914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | MA
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