| NPI | 1366509473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L VAILL Manager Provider Enrollment 413-794-7976 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| 207X00000X Orthopaedic Surgery | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| 2086S0127X Surgery Trauma Surgery | |
| 2086X0206X Surgery Surgical Oncology | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 2086S0129X Surgery Vascular Surgery | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| 363LA2100X Nurse Practitioner Acute Care | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2014-02-26 |