Provider Demographics
NPI:1407819626
Name:BACH, NEIL D (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:D
Last Name:BACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1979
Mailing Address - Country:US
Mailing Address - Phone:413-748-6484
Mailing Address - Fax:
Practice Address - Street 1:146 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2511
Practice Address - Country:US
Practice Address - Phone:413-774-2222
Practice Address - Fax:413-774-2225
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48251207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB33683OtherBCBS OF MASS
MA0094507OtherCIGNA HEALTHCARE
MA26369OtherHEALTH NEW ENGLAND
MA3159680Medicaid
MA116718OtherAETNA
MA482511OtherCONNECTICARE
MAAA44717OtherHARVARD PILGRIM HEALTHCAR
MA048251OtherTUFTS HEALTH PLAN
MD31175OtherBMC HEALTHNET
MAF02438Medicare UPIN
MAB33683Medicare ID - Type Unspecified