Provider Demographics
NPI:1508894676
Name:ADLER, MARY F (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:ADLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2150 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104
Mailing Address - Country:US
Mailing Address - Phone:413-739-5676
Mailing Address - Fax:413-739-2278
Practice Address - Street 1:701 ENFIELD ST
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-2961
Practice Address - Country:US
Practice Address - Phone:860-741-6058
Practice Address - Fax:860-741-6864
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2010-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA157892207R00000X
CT38965207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010038965CT01OtherBLUE CROSS BLUE SHIELD CT
MA157892OtherTUFTS HEALTH PLAN
MA23516OtherHEALTH NEW ENGLAND
MA3188035Medicaid
MAJ19638OtherBLUE CROSS BLUE SHIELD MA
MA3188035Medicaid
MA23516OtherHEALTH NEW ENGLAND