Provider Demographics
NPI:1386685402
Name:WHALEN, EILEEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:A
Last Name:WHALEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W SILVER ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-3678
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:57 UNION ST
Practice Address - Street 2:STE 101
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-2658
Practice Address - Country:US
Practice Address - Phone:413-642-7200
Practice Address - Fax:413-562-1821
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156133207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000033015OtherBMC HEALTH NET
MA25320OtherHEALTHCARE NEW ENGLAND
MA930094815OtherRAILROAD MEDICARE
MA3178340Medicaid
MAWHJ18833OtherBLUE SHIELD
MAWHJ18833OtherBLUE SHIELD