Provider Demographics
NPI:1558433995
Name:JACOME, DANIEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:JACOME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:7 BURNHAM ST
Practice Address - Street 2:SUITE 2
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1841
Practice Address - Country:US
Practice Address - Phone:413-773-8808
Practice Address - Fax:413-773-8801
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2016-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA797962084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3114325Medicaid
MIJ14748Medicare UPIN
MAJ14748OtherBLUE CROSS BLUE SHIELD