Organization
AMBULATORY CARE PHYSICIANS
Active
Parent organization
COOLEY DICKINSON HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
COOLEY DICKINSON HOSPITAL
Authorized official
DR. KHAMA ENNIS M.D. (EMERGENCY MEDICINE PHYSICIAN)
(413) 582-5299
Entity
Organization
Contact information
Practice address
30 LOCUST ST, NORTHAMPTON, MA 01060-2052
(413) 582-2363
Mailing address
304 CITY VIEW AVE, WEST SPRINGFIELD, MA 01089-2511
(413) 896-4620
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
PA5932
MA
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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