1326136128 NPI number — AMY VERES PT

Table of content: AMY VERES PT (NPI 1326136128)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326136128 NPI number — AMY VERES PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VERES
Provider First Name:
AMY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
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:
1326136128
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
168 DENSLOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST LONGMEADOW
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01028-3188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-526-9969
Provider Business Mailing Address Fax Number:
413-526-9960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
168 DENSLOW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST LONGMEADOW
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01028-3188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-526-9969
Provider Business Practice Location Address Fax Number:
413-526-9960
Provider Enumeration Date:
10/10/2006

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: 225100000X , with the licence number:  13277 , 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)

  • Identifier: 28117 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7339777 . This is a "AETNA INDIVIDUAL NO." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "UNICARE/GIC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "GREATWEST" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0799637 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00244067 . This is a "PALMETTO RR MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000035264 . This is a "BOSTON MEDICAL HEALTH NET GROUP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "CONSOLIDATED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 494428 . This is a "TUFTS INDIVIDUAL NO." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "AETNA GROUP NO." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "NORTH REGION/ TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "PIONEER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0800013277MA01 . This is a "ANTHEM BC BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 103355100 . This is a "DEPARTMENT OF LABOR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3775887 . This is a "CIGNA INDIVIDUAL PROVIDER NO." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 690675 . This is a "TUFTS GROUP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043527497 . This is a "CONNECTICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 11535153 . This is a "CAQH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000035327 . This is a "BOSTON MEDICAL HEALTH NET INDIVIDUAL NO." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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