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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