1124197918 NPI number — BARBARA ANNE DUNNE ED.D.

Table of content: BARBARA ANNE DUNNE ED.D. (NPI 1124197918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124197918 NPI number — BARBARA ANNE DUNNE ED.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNNE
Provider First Name:
BARBARA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ED.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124197918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 STEIGER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLYOKE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01040-1330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-374-8224
Provider Business Mailing Address Fax Number:
413-315-3922

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1242 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01103-1915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-315-3154
Provider Business Practice Location Address Fax Number:
413-315-3922
Provider Enumeration Date:
11/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002813 . This is a "CONNECTICUT STATE LICENSE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 8844 . This is a "MA PSYCHOLOGY LICENSE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 02920230 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 017292 . This is a "NEW YORK STATE LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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