Provider Demographics
NPI:1356438782
Name:LARIVIERE, MELISSA M (PA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:LARIVIERE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:280 CHESTNUT ST
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:
Practice Address - Street 1:115 W. SILVER ST
Practice Address - Street 2:STE 2032
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3678
Practice Address - Country:US
Practice Address - Phone:413-568-2811
Practice Address - Fax:413-794-1767
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2025-01-29
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Provider Licenses
StateLicense IDTaxonomies
MA2171363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical