Provider Demographics
NPI:1952398034
Name:CITY OF CHICOPEE
Entity Type:Organization
Organization Name:CITY OF CHICOPEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMBORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-594-1630
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:
Practice Address - Street 1:80 CHURCH ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-1871
Practice Address - Country:US
Practice Address - Phone:413-594-1630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3349341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1707205Medicaid
MA1707205Medicaid
0009059OtherNEIGHBORHOOD HEALTH
758365OtherCONNECTICARE
MB2784OtherHEALTH NET OF NORTHEAST
441590469OtherRR MEDICARE
801407OtherSECURE HORIZONS
000000021058OtherBMC HEALTHNET PLAN
801407OtherTUFTS HEALTH PLAN
MA076459OtherBLUE CROSS BLUE SHEILD
249576700OtherDEPARTMENT OF LABOR
CT700263OtherHARVARD PILGRIM
MB2784OtherHEALTH NET OF NORTHEAST