Provider Demographics
NPI:1730668013
Name:CARRERAS, VICTOR (PA-C)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:CARRERAS
Suffix:
Gender:M
Credentials:PA-C
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 STE 102
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1375
Mailing Address - Country:US
Mailing Address - Phone:413-785-5344
Mailing Address - Fax:
Practice Address - Street 1:300 BIRNIE AVE STE 102
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1375
Practice Address - Country:US
Practice Address - Phone:413-785-5344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA6696363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical