Individual
DR. JOSE O FRAGOSA-ALVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS-PSYCHOLOGY
Contact information
Practice address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 846-4300
Mailing address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 846-4300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295 (MH)
—
MA
05
—
1307576 (SA)
—
MA
01
—
M18463
BLUE CROSS / BLUE SHIELD
—
Enumeration date
12/06/2010
Last updated
02/12/2014
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