Organization
NORTHEND MEDICAL ASSOCIATES INC
Active
Other names
RAINBOW PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
AKINNIYI BABASOLA ODUTOLA M.D. (MEMBER)
(413) 241-6152
Entity
Organization
Contact information
Practice address
475 SUMNER AVE, SPRINGFIELD, MA 01108-2321
(413) 241-6152
(413) 241-6153
Mailing address
84 LAWRENCE DR, LONGMEADOW, MA 01106-1618
(413) 241-6152
(413) 241-6153
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
210668
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049627
BOSTON MEDICAL CENTER HEALTHNET
MA
01
—
0007987
PTAN
MA
01
—
0045591
NEIGHBORHOOD HEALTH PLAN
MA
01
—
1915999
AETNA
—
01
—
3036020; 3036024
UNITED HEALTH
—
05
—
9738550 / 110080708A
—
MA
01
—
A3503501
GROUP MEMBER: AKINNIYI B. ODUTOLA; NPI 1588629240
—
Enumeration date
07/08/2008
Last updated
03/11/2016
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