Organization
NEW ENGLAND CENTER FOR FUNCTIONAL MEDICINE PC
Active
Organization
NEW ENGLAND CENTER FOR FUNCTIONAL MEDICINE PC
Active
Other names
Pioneer Valley Weight and Wellness Centers
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER R KEROACK MD (MEDICAL DIRECTOR)
(413) 205-1200
Entity
Organization
Contact information
Practice address
2 MEDICAL CENTER DR, SUITE 202, SPRINGFIELD, MA 01107
(413) 205-1200
(413) 205-1220
Mailing address
2 MEDICAL CENTER DR, SUITE 202, SPRINGFIELD, MA 01107
(413) 205-1200
(413) 205-1220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M19415
BCBS
MA
Enumeration date
04/10/2007
Last updated
11/07/2022
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