Provider Demographics
NPI:1114032315
Name:PAPPAS, DALE C (PA-C)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:C
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CAREW ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2391
Mailing Address - Country:US
Mailing Address - Phone:413-732-4269
Mailing Address - Fax:413-785-4619
Practice Address - Street 1:175 CAREW ST STE 200
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2391
Practice Address - Country:US
Practice Address - Phone:413-732-4269
Practice Address - Fax:413-785-4619
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1296363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical