Basic Information
| Provider Information | |||||||||
| NPI: | 1730287467 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | D'ALESSANDRO | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3640 MAIN ST | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011071145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137390669 | ||||||||
| FaxNumber: | 4137390621 | ||||||||
| Practice Location | |||||||||
| Address1: | 3640 MAIN ST | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011071145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137390669 | ||||||||
| FaxNumber: | 4137390621 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 07/13/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 78578 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 78578 | MA | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.