Provider Demographics
NPI:1881913002
Name:STEVEN J COVICI MD FACS PC
Entity type:Organization
Organization Name:STEVEN J COVICI MD FACS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:COVICI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-737-7300
Mailing Address - Street 1:125 LIBERTY ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1114
Mailing Address - Country:US
Mailing Address - Phone:413-737-7300
Mailing Address - Fax:413-737-7377
Practice Address - Street 1:125 LIBERTY ST
Practice Address - Street 2:SUITE 308
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1114
Practice Address - Country:US
Practice Address - Phone:413-737-7300
Practice Address - Fax:413-737-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA2836601Medicare UPIN