Provider Demographics
NPI:1114033271
Name:DAMATO, ALFRED A (EDD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:A
Last Name:DAMATO
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ELLIOT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01102-1730
Mailing Address - Country:US
Mailing Address - Phone:413-452-0621
Mailing Address - Fax:413-452-0618
Practice Address - Street 1:65 ELLIOT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01102-1730
Practice Address - Country:US
Practice Address - Phone:413-452-0621
Practice Address - Fax:413-452-0618
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200685104100000X
MA93106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker