| Physician Care West Pc | |
|
274 Westfield St West Springfield MA 01089-2572 | |
| (413) 733-1900 | |
| Not Available |
| Full Name | Physician Care West Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 274 Westfield St, West Springfield, Massachusetts |
| Authorized Official Name and Position | Reda Ishak (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4137331900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Care West Pc 274 Westfield St West Springfield MA 01089-2572 Ph: (413) 733-1900 | Physician Care West Pc 274 Westfield St West Springfield MA 01089-2572 Ph: (413) 733-1900 |
| NPI Number | 1760594493 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 03/01/2011 |
| Medicare PECOS PAC ID | 6901800044 |
|---|---|
| Medicare Enrollment ID | O20060905000180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760594493 | NPI | - | NPPES |
| 80712 | Other | MA | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 80712 (Massachusetts) | Primary |
| Provider Name | Reda H Ishak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366428013 PECOS PAC ID: 1759399868 Enrollment ID: I20060331000313 |
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