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Organization
BAYSTATE MEDICAL PRACTICES, INC
Active
Organization
BAYSTATE MEDICAL PRACTICES, INC
Active
Parent organization
BAYSTATE MEDICAL PRACTICES, INC
Other names
BMP, Dept of Pathology
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYSTATE MEDICAL PRACTICES, INC
Authorized official
RANDALL L VAILL JR. (MANAGER PROVIDER ENROLLMENT)
(413) 794-7976
Entity
Organization
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-1001
(413) 794-5700
(413) 794-1629
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
(413) 794-5700
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
—
207ZC0006X
Clinical Pathology Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZM0300X
Medical Microbiology Physician
—
—
207ZN0500X
Neuropathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
01/02/2007
Last updated
02/26/2014
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