Individual
LARISA ALTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
271 CAREW ST, SPRINGFIELD, MA 01104-2377
(413) 748-9349
(413) 794-1629
Mailing address
271 CAREW ST, SPRINGFIELD, MA 01104-2377
(413) 748-9349
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
002903
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
RN169231
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004029039
—
CT
05
—
110080335A
—
MA
Enumeration date
06/01/2007
Last updated
06/14/2019
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