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Organization
NORTHEND MEDICAL ASSOCIATES INC
Active
Organization
NORTHEND MEDICAL ASSOCIATES INC
Active
Other names
RAINBOW PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
AKINNIYI BABASOLA ODUTOLA M.D. (MEMBER)
(413) 241-6152
Entity
Organization
Contact information
Practice address
475 SUMNER AVE, SPRINGFIELD, MA 01108-2321
(413) 241-6152
(413) 241-6153
Mailing address
84 LAWRENCE DR, LONGMEADOW, MA 01106-1618
(413) 241-6152
(413) 241-6153
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
210668
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049627
BOSTON MEDICAL CENTER HEALTHNET
MA
01
—
0007987
PTAN
MA
01
—
0045591
NEIGHBORHOOD HEALTH PLAN
MA
01
—
1915999
AETNA
—
01
—
3036020; 3036024
UNITED HEALTH
—
05
—
9738550 / 110080708A
—
MA
01
—
A3503501
GROUP MEMBER: AKINNIYI B. ODUTOLA; NPI 1588629240
—
Enumeration date
07/08/2008
Last updated
03/11/2016
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