Provider Demographics
NPI:1396766424
Name:ENDOCRINE ASSOCIATES OF WESTERN MASS, P.C.
Entity type:Organization
Organization Name:ENDOCRINE ASSOCIATES OF WESTERN MASS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:Z
Authorized Official - Last Name:IZENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-734-4661
Mailing Address - Street 1:2 MEDICAL CENTER DR
Mailing Address - Street 2:STE. 210
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1270
Mailing Address - Country:US
Mailing Address - Phone:413-734-4661
Mailing Address - Fax:413-737-1930
Practice Address - Street 1:2 MEDICAL CENTER DR
Practice Address - Street 2:STE. 210
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1270
Practice Address - Country:US
Practice Address - Phone:413-734-4661
Practice Address - Fax:413-737-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
M09818Medicare PIN