Provider Demographics
NPI:1598202558
Name:KIDNEY CARE AND TRANSPLANT SERVICES OF NEW ENGLAND, PC
Entity Type:Organization
Organization Name:KIDNEY CARE AND TRANSPLANT SERVICES OF NEW ENGLAND, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULHERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-733-0010
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-0366
Mailing Address - Country:US
Mailing Address - Phone:413-733-0010
Mailing Address - Fax:413-930-2108
Practice Address - Street 1:2150 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3566
Practice Address - Country:US
Practice Address - Phone:413-733-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty