Provider Demographics
NPI:1639160161
Name:WESTERN NEW ENGLAND RENAL AND TRANSPLANT ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:WESTERN NEW ENGLAND RENAL AND TRANSPLANT ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-733-9666
Mailing Address - Street 1:PO BOX 70266
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1577
Mailing Address - Country:US
Mailing Address - Phone:413-788-6530
Mailing Address - Fax:413-750-8027
Practice Address - Street 1:100 WASON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1119
Practice Address - Country:US
Practice Address - Phone:413-733-9666
Practice Address - Fax:413-750-3432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1005965Medicaid
NH30010539Medicaid
MAM16494OtherBLUE CROSS
CT4173530Medicaid
FL9123733Medicaid
MA9779124Medicaid
FL9123733Medicaid
VT1005965Medicaid
CT4173530Medicaid