1538212352 NPI number — HAMPDEN PODIATRY ASSOCIATES

Table of content: DR. NICOLE CHRISTINE BURNS CRNA (NPI 1881471779)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538212352 NPI number — HAMPDEN PODIATRY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMPDEN PODIATRY ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1538212352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
77 WINSOR ST
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
LUDLOW
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01056-3469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-589-7287
Provider Business Mailing Address Fax Number:
413-547-8065

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
77 WINSOR ST
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
LUDLOW
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01056-3469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-589-7287
Provider Business Practice Location Address Fax Number:
413-547-8065
Provider Enumeration Date:
01/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VOMERO
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
413-589-7287

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  1779 , 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: 0361445 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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