Provider Demographics
NPI:1760491377
Name:PAPALE, JOHN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:PAPALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1515 ALLEN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1803
Mailing Address - Country:US
Mailing Address - Phone:413-782-0030
Mailing Address - Fax:413-796-1985
Practice Address - Street 1:1515 ALLEN ST
Practice Address - Street 2:SUITE E
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1803
Practice Address - Country:US
Practice Address - Phone:413-782-0030
Practice Address - Fax:413-796-1985
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46264207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA123629OtherAETNA
MAJ04563OtherBLUE CROSS BLUE SHIELD
MA3067874Medicaid
MA046264OtherTUFTS
MA46264OtherMASSACHUSETTS LICENSE
MAJ04563Medicare ID - Type UnspecifiedMEDICARE
MAJ04563OtherBLUE CROSS BLUE SHIELD