| NPI | 1104513951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCESITA SCAMMON Program Manager 413-213-2918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2024-03-11 |