Provider Demographics
NPI:1649369133
Name:ACKERMAN, TEDD H (MD)
Entity type:Individual
Prefix:
First Name:TEDD
Middle Name:H
Last Name:ACKERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOLYOKE HOSPITAL
Mailing Address - Street 2:575 BEECH STREET
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040
Mailing Address - Country:US
Mailing Address - Phone:413-534-2697
Mailing Address - Fax:413-534-2724
Practice Address - Street 1:HOLYOKE HOSPITAL
Practice Address - Street 2:575 BEECH STREET
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-534-2697
Practice Address - Fax:413-534-2724
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA788102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry