Individual
STEPHANIE SAAL AVILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
ENFIELD MEDICAL ASSOCIATES, 701 ENFIELD STREET, ENFIELD, CT 06082
(860) 741-6058
(413) 733-5860
Mailing address
SPRINGFIELD MEDICAL ASSOCIATES, INC, 2150 MAIN STREET, SPRINGFIELD, MA 01104
(413) 739-5676
(413) 733-5860
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5910
MA
363A00000X
Physician Assistant
PA-4817
MA
363A00000X
Physician Assistant
PA4817
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110110336A
—
MA
Enumeration date
08/29/2013
Last updated
12/07/2022
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