MEDICARE: MICHELLE L MCGRATH NP

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	363LA2200X	Adult Health Nurse Practitioner	198017	MA

General Provider Information

NPI Number	:	1366451767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE L MCGRATH NP

Provider Business Mailing Address
First Line	:	280 CHESTNUT ST
Second Line	:	2ND FLOOR
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1000
Country	:	US
Telephone Number	:	413-197-5700
Fax Number	:	413-794-1629

Provider Business Practice Location Address
First Line	:	3300 MAIN ST
Second Line	:	2ND FLOOR SUITE A
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1002
Country	:	US
Telephone Number	:	413-794-7246
Fax Number	:	413-794-7131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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