MEDICARE: MS. MARGARET A MASTRANGELO FNP

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	363LF0000X	Family Nurse Practitioner	205310	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
2	205310	OTHER	MA	CONNECTICARE OF MA
3	NP2188	OTHER	MA	BLUE CROSS/BLUE SHIELD
4	043202198007	OTHER		TRICARE
5	NP2188	OTHER		HMO BLUE
6	043202198	OTHER		CBA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	043202198	OTHER		BEECH STREET

General Provider Information

NPI Number	:	1568462448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET A MASTRANGELO FNP

Provider Business Mailing Address
First Line	:	260 NEW LUDLOW RD
Second Line	:	WESTERN MASS PHYSICIAN ASSOCIATES, INC.
City	:	CHICOPEE
State	:	MA
Zip	:	01020-4324
Country	:	US
Telephone Number	:	413-533-3470
Fax Number	:	413-533-6859

Provider Business Practice Location Address
First Line	:	262 NEW LUDLOW RD
Second Line	:	CHICOPEE MEDICAL CENTER
City	:	CHICOPEE
State	:	MA
Zip	:	01020-4324
Country	:	US
Telephone Number	:	413-552-3250
Fax Number	:	413-552-3255

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/31/2012

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