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Organization

UROLOGY GROUP OF WESTERN NEW ENGLAND, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOHAMMAD R MOSTAFAVI M.D. (PRESIDENT)
(413) 785-5321
Entity
Organization

Contact information

Practice address
3640 MAIN ST, SUITE 103, SPRINGFIELD, MA 01107-1145
(413) 785-5321
(413) 731-7130
Mailing address
3640 MAIN ST, SUITE 103, SPRINGFIELD, MA 01107-1145
(413) 785-5321
(413) 731-7130

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
207ZP0101X
Anatomic Pathology Physician
208800000X
Urology Physician
Primary

Other

Enumeration date
10/24/2006
Last updated
06/15/2021
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