Provider Demographics
NPI:1700855053
Name:FAIRVIEW PEDIATRICS
Entity Type:Organization
Organization Name:FAIRVIEW PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-593-1333
Mailing Address - Street 1:1176 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-3958
Mailing Address - Country:US
Mailing Address - Phone:413-593-1333
Mailing Address - Fax:413-593-1444
Practice Address - Street 1:1176 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3958
Practice Address - Country:US
Practice Address - Phone:413-593-1333
Practice Address - Fax:413-593-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205617208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3209156Medicaid
MAJ22280OtherBCBS
MA205617OtherCONNECTICARE
MA202357OtherPILGRIM
MA01020561MA01OtherBCBS CONN
MA7859OtherHEALTHNET
MA26476OtherHEALTH NEW ENGLAND
MA7859OtherHEALTHNET