Provider Demographics
NPI:1437352952
Name:VEHSE, NICO W (MD)
Entity Type:Individual
Prefix:
First Name:NICO
Middle Name:W
Last Name:VEHSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:413-794-1629
Practice Address - Street 1:50 WASON AVE
Practice Address - Street 2:1ST FL
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1274
Practice Address - Country:US
Practice Address - Phone:413-794-5437
Practice Address - Fax:413-794-7408
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2575482080P0214X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMD13375OtherLICENSE