Physician Care West Pc | |
274 Westfield St West Springfield MA 01089-2572 | |
(413) 733-1900 | |
Not Available |
Full Name | Physician Care West Pc |
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Speciality | Clinic/Center |
Location | 274 Westfield St, West Springfield, Massachusetts |
Authorized Official Name and Position | Reda Ishak (MEDICAL DIRECTOR) |
Authorized Official Contact | 4137331900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Physician Care West Pc 274 Westfield St West Springfield MA 01089-2572 Ph: (413) 733-1900 | Physician Care West Pc 274 Westfield St West Springfield MA 01089-2572 Ph: (413) 733-1900 |
NPI Number | 1760594493 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 03/01/2011 |
Medicare PECOS PAC ID | 6901800044 |
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Medicare Enrollment ID | O20060905000180 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760594493 | NPI | - | NPPES |
80712 | Other | MA | LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 80712 (Massachusetts) | Primary |
Provider Name | Reda H Ishak |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366428013 PECOS PAC ID: 1759399868 Enrollment ID: I20060331000313 |
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