1962758193 NPI number — DR. KATARZYNA BABINSKI O.D.

Table of content: DR. KATARZYNA BABINSKI O.D. (NPI 1962758193)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962758193 NPI number — DR. KATARZYNA BABINSKI O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BABINSKI
Provider First Name:
KATARZYNA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
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:
1962758193
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CENTER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUDLOW
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01056-2772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-583-3600
Provider Business Mailing Address Fax Number:
413-589-0783

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 BICENTENNIAL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01118-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-783-3100
Provider Business Practice Location Address Fax Number:
413-782-7998
Provider Enumeration Date:
07/25/2012

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: 152W00000X , with the licence number:  4922 , 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: 55946 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110093721A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 122569 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 93253302 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 049022 . This is a "CONNECTICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 93253301 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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