MEDICARE: SMALL MEASURES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD1600X	Developmental Disabilities Clinic/Center	159491	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174760094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMALL MEASURES LLC

Provider Business Mailing Address
First Line	:	55 CHILSON RD
Second Line	:
City	:	WILBRAHAM
State	:	MA
Zip	:	01095-1203
Country	:	US
Telephone Number	:	877-454-3710
Fax Number	:	413-596-2317

Provider Business Practice Location Address
First Line	:	95 POST OFFICE PARK
Second Line	:	SUITE A
City	:	WILBRAHAM
State	:	MA
Zip	:	01095-1248
Country	:	US
Telephone Number	:	877-454-3710
Fax Number	:	413-596-2317

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. CHERYL DAWN TIERNEY
Credential	:	MD
Telephone Number	:	18774543710

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	01/14/2009

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Directions to “SMALL MEASURES LLC ” Practice Location

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