Individual
JUAN FELIX FUMERO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 304-2913
Mailing address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295
—
MA
05
—
1307576
—
MA
01
—
M18463
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
03/28/2012
Last updated
06/16/2015
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