Provider Demographics
NPI:1336668326
Name:WESTERN MASS NEUROLOGY PC
Entity Type:Organization
Organization Name:WESTERN MASS NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MELCHIONNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-427-5401
Mailing Address - Street 1:175 CAREW ST STE 140
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2389
Mailing Address - Country:US
Mailing Address - Phone:413-737-4100
Mailing Address - Fax:
Practice Address - Street 1:175 CAREW ST STE 140
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2389
Practice Address - Country:US
Practice Address - Phone:413-427-5401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty