Organization
BAYSTATE MEDICAL PRACTICES, INC
Active
Parent organization
BAYSTATE MEDICAL PRACTICES, INC
Other names
BMP, Dept of Psychiatry
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
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
(413) 794-5700
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
Other
Enumeration date
12/29/2006
Last updated
02/26/2014
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