Provider Demographics
NPI:1861493132
Name:BRADY, ELIZABETH W (MD)
Entity Type:Individual
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First Name:ELIZABETH
Middle Name:W
Last Name:BRADY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:413-794-1629
Practice Address - Street 1:100 WASON AVENUE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1179
Practice Address - Country:US
Practice Address - Phone:413-794-5265
Practice Address - Fax:413-794-1794
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-01-18
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Provider Licenses
StateLicense IDTaxonomies
MA2703552086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0003031 001OtherCIGNA
CT061200871OtherGREAT WEST HEALTHCARE
CT782084OtherAETNA
CT001261296Medicaid
CT10790OtherHEALTH NEW ENGLAND
CT06-1406459OtherCOLONIAL COOPERATIVE CARE
CT061200871OtherNORTHEAST HEALTH DIRECT CHN PPO
CT061200871OtherMULTIPLAN PHCS
CT0S2066OtherHEALTH NET
CT010026129CT03OtherANTHEM BCBS
CT026129-0403OtherCONNECTICARE
CT061200871OtherUNITED HEALTHCARE
CT061200871OtherCORVEL
CT06-1406459OtherPIONEER
CT061200871OtherCOVENTRY/FIRST HEALTH
MA3163547OtherMASSHEALTH
CTP825539OtherOXFORD
CT0003031 001OtherCIGNA
CT06-1406459OtherCOLONIAL COOPERATIVE CARE
CT10790OtherHEALTH NEW ENGLAND