MEDICARE: RECOVERY HEALTH PROFESSIONAL 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	261QP2300X	Primary Care Clinic/Center
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1780277368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY HEALTH PROFESSIONAL LLC

Provider Business Mailing Address
First Line	:	24 GRASSY MEADOW RD
Second Line	:
City	:	WILBRAHAM
State	:	MA
Zip	:	01095-1446
Country	:	US
Telephone Number	:	413-824-4070
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 DWIGHT RD STE 102
Second Line	:
City	:	LONGMEADOW
State	:	MA
Zip	:	01106-1768
Country	:	US
Telephone Number	:	413-824-4070
Fax Number	:	413-216-3304

Authorized Official
Title or Position	:	CEO
Name	:	DR. EMA UKO-ABASI
Credential	:
Telephone Number	:	413-824-4070

Provider Enumeration Date	:	02/16/2021
Last Update Date	:	02/23/2023

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Directions to “RECOVERY HEALTH PROFESSIONAL LLC ” Practice Location

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