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Organization
BAYSTATE MEDICAL PRACTICES, INC
Active
Organization
BAYSTATE MEDICAL PRACTICES, INC
Active
Parent organization
BAYSTATE MEDICAL PRACTICES, INC.
Other names
GTR Springfield Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYSTATE MEDICAL PRACTICES, INC.
Authorized official
DEBRA A. CREMONTI (DIRECTOR OF MEDICAL STAFF SERVICES)
(413) 794-5508
Entity
Organization
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
05/20/2010
Last updated
05/20/2010
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