Provider Demographics
NPI:1649347659
Name:NEUROLOGICAL ASSOCIATES OF WESTERN MA
Entity type:Organization
Organization Name:NEUROLOGICAL ASSOCIATES OF WESTERN MA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:HAZRATJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-534-5135
Mailing Address - Street 1:15 HOSPITAL DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6606
Mailing Address - Country:US
Mailing Address - Phone:413-534-5135
Mailing Address - Fax:413-534-3328
Practice Address - Street 1:15 HOSPITAL DR
Practice Address - Street 2:SUITE 401
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6606
Practice Address - Country:US
Practice Address - Phone:413-534-5135
Practice Address - Fax:413-534-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT130000085OtherMEDICARE OF CT
MAM17327OtherBS
MADB5703OtherRAILROAD MEDICARE
MA9715461Medicaid
MAM21446Medicare PIN