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NPI Code Detail

MEDICARE: IRENA PALUCH OD

MEDICARE: IRENA PALUCH OD
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
1152W00000XOptometrist4163MA

Other Identifiers

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

General Provider Information

NPI Number : 1295850592
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENA PALUCH OD
Provider Business Mailing Address
First Line : 336 LONGHILL ST
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01108-1407
Country : US
Telephone Number : 413-739-0040
Fax Number :
Provider Business Practice Location Address
First Line : 98 LOWER WESTFIELD RD
Second Line :
City : HOLYOKE
State : MA
Zip : 01040-9403
Country : US
Telephone Number : 413-552-3937
Fax Number : 888-935-4545
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 08/03/2009

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