Organization
PHYSICIAN CARE WEST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REDA ISHAK MD (MEDICAL DIRECTOR)
(413) 733-1900
Entity
Organization
Contact information
Practice address
274 WESTFIELD ST, WEST SPRINGFIELD, MA 01089-2572
(413) 733-1900
Mailing address
274 WESTFIELD ST, WEST SPRINGFIELD, MA 01089-2572
(413) 733-1900
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
80712
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80712
LICENSE NUMBER
MA
Enumeration date
08/31/2006
Last updated
03/01/2011
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