1922280080 NPI number — FRANK S. MOLE, DPM

Table of content: (NPI 1922280080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922280080 NPI number — FRANK S. MOLE, DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANK S. MOLE, DPM
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:
1922280080
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2440 BOSTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILBRAHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01095-1251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-596-8800
Provider Business Mailing Address Fax Number:
413-599-1296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2440 BOSTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILBRAHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01095-1251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-596-8800
Provider Business Practice Location Address Fax Number:
413-599-1296
Provider Enumeration Date:
11/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOLE
Authorized Official First Name:
ANN
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
413-596-8800

Provider Taxonomy Codes

  • Taxonomy code: 213EP1101X , with the licence number:  1910 , 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: 0702676 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10112548 . This is a "CDPHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 001910 . This is a "CONNECTICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 14533 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 98161701 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 030001910MA01 . This is a "ANTHEM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 480013360 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 27-00921 . This is a "EVERCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 74373 . This is a "FIRST HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4255592 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 76343 . This is a "US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 001910 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2704384 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9147847 . This is a "PHCS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000026339 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 33934 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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