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Individual

DEBRA A. DISANDRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3550 MAIN ST STE 302, SPRINGFIELD, MA 01107-1088
(413) 781-8290
(413) 737-8540
Mailing address
3550 MAIN ST STE 302, SPRINGFIELD, MA 01107-1088
(413) 781-8290
(413) 732-7628

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
52978
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000006311
BMC HEALTHNET
MA
01
0010789
NEIGHBORHOOD HEALTH
MA
01
037323836
TRICARE
MA
01
07-04622
UNITED HEALTHCARE
MA
01
11833
HEALTH NEW ENGLAND
MA
01
130705
PILGRIM
MA
01
160039235
RR MEDICARE
MA
05
3017699
MA
01
484978
CONNECTICARE
MA
01
717957
TUFTS
MA
01
782507
US HEALTHCARE
MA
01
DIJ06185
BLUE SHIELD OF MASS
MA
Enumeration date
07/19/2005
Last updated
03/07/2019
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