1730296906 NPI number — KATHRYN YUKO BARZILAI NURSE PRACTITIONER

Table of content: KENDRA CUNNINGHAM LMHC (NPI 1295337384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730296906 NPI number — KATHRYN YUKO BARZILAI NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARZILAI
Provider First Name:
KATHRYN
Provider Middle Name:
YUKO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARZILAI
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
YUKO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CASTELLANO
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730296906
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
280 CHESTNUT STREET
Provider Second Line Business Mailing Address:
2ND FL
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01199-1001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-794-5000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 CAPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01089-1350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-794-6411
Provider Business Practice Location Address Fax Number:
413-794-6685
Provider Enumeration Date:
08/24/2006

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: 363LG0600X , with the licence number:  RN2258167 , 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)





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