1093036766 NPI number — PAUL FRANCIS SAHD D.O.

Table of content: PAUL FRANCIS SAHD D.O. (NPI 1093036766)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093036766 NPI number — PAUL FRANCIS SAHD D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAHD
Provider First Name:
PAUL
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

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:
1093036766
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 911
Provider Second Line Business Mailing Address:
30 LOCUST ST
Provider Business Mailing Address City Name:
NORTHAMPTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01061-0911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-582-2898
Provider Business Mailing Address Fax Number:
413-582-2958

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 RUSSELL STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HADLEY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-586-6020
Provider Business Practice Location Address Fax Number:
413-923-9307
Provider Enumeration Date:
06/17/2010

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: 207Q00000X , with the licence number:  256644 , 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: J52039 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: S400102537 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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