| Valley Optimal Health, Pc | |
|
8 River Dr Hadley MA 01035-3540 | |
| (413) 582-1839 | |
| (413) 582-6855 |
| Full Name | Valley Optimal Health, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8 River Dr, Hadley, Massachusetts |
| Authorized Official Name and Position | Bruce I Goderez (OWNER) |
| Authorized Official Contact | 4135821839 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Optimal Health, Pc Po Box 380 Hadley MA 01035-0380 Ph: (413) 582-1839 | Valley Optimal Health, Pc 8 River Dr Hadley MA 01035-3540 Ph: (413) 582-1839 |
| NPI Number | 1326550435 |
|---|---|
| Provider Enumeration Date | 10/30/2017 |
| Last Update Date | 02/15/2024 |
| Certification Date | 02/15/2024 |
| Medicare PECOS PAC ID | 7416213442 |
|---|---|
| Medicare Enrollment ID | O20171108000926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326550435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 50762 (Massachusetts) | Primary |
| Provider Name | Bruce I Goderez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023165503 PECOS PAC ID: 8729021993 Enrollment ID: I20050608000629 |
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