1275785958 NPI number — ANNEMARIE ROSARY BARTELS

Table of content: ANNEMARIE ROSARY BARTELS (NPI 1275785958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275785958 NPI number — ANNEMARIE ROSARY BARTELS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARTELS
Provider First Name:
ANNEMARIE
Provider Middle Name:
ROSARY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARTELS
Provider Other First Name:
ANNEMARIE
Provider Other Middle Name:
ROSARY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1275785958
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1015 HILLSIDE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALMER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01069-2179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-283-9969
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
819 WORCESTER ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01151-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-543-6820
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2008

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: 363LA2200X , with the licence number:  250847 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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