Individual
LYNN BUJNEVICIE LAROCHELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
300 STAFFORD ST, #154, SPRINGFIELD, MA 01104-4110
(413) 781-5735
Mailing address
300 STAFFORD ST, #154, SPRINGFIELD, MA 01104-4110
(413) 781-5735
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
001164
CT
363AM0700X
Medical Physician Assistant
Primary
1379
MA
363AS0400X
Surgical Physician Assistant
PA1379
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1379
LICENSE
MA
Enumeration date
10/13/2006
Last updated
02/11/2015
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