1427058312 NPI number — MS. JANE M FREY CNM

Table of content: MS. JANE M FREY CNM (NPI 1427058312)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427058312 NPI number — MS. JANE M FREY CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FREY
Provider First Name:
JANE
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CNM
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:
1427058312
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WESTERN MASS PHYSICIAN ASSOCIATES INC
Provider Second Line Business Mailing Address:
260 NEW LUDLOW RD
Provider Business Mailing Address City Name:
CHICOPEE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-533-3470
Provider Business Mailing Address Fax Number:
413-533-6859

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MIDWIFERY CARE OF HOLYOKE
Provider Second Line Business Practice Location Address:
267 HIGH ST
Provider Business Practice Location Address City Name:
HOLYOKE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-535-4700
Provider Business Practice Location Address Fax Number:
413-535-4704
Provider Enumeration Date:
07/21/2005

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: 367A00000X , with the licence number:  165319 , 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: 0702013 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 043202198008 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21220007201 . This is a "BEECH STREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 37372 . This is a "HEALTHY START" identifier . This identifiers is of the category "OTHER".
  • Identifier: CN0094 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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