Provider Demographics
NPI:1659505519
Name:HAAS, JAMES (CO)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:HAAS
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BIRNIE AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1107
Mailing Address - Country:US
Mailing Address - Phone:413-737-2404
Mailing Address - Fax:413-733-1389
Practice Address - Street 1:163 SOUTH ST
Practice Address - Street 2:UNIT 2
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6988
Practice Address - Country:US
Practice Address - Phone:413-442-0017
Practice Address - Fax:413-442-0020
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO004133174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1540408Medicaid
CT3048436Medicaid
VT1009994Medicaid
15121OtherHNE
MA000000006888OtherBMC
0008938OtherNHP
553174OtherAETNA
734427OtherCONNECTICARE
803119OtherTUFTS
65955037OtherVA
701312OtherHARVARD PLIGRIM
MA833821OtherMVP
MA360154OtherBCBS
43871OtherFALLON
MA475460OtherCIGNA
MAS009509OtherTRICARE
553174OtherAETNA