Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003320052 |
---|---|
Provider Name | Iria Melendez Perez |
First Address | Springfield, MA 01103-2203 |
Second Address | Springfield, MA 01103-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2017 |
Last Update Date | 29/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042622756 | CCA (01) | MA |
1134107113 | (05) | MA |
1134107113 | BEACON (01) | MA |
1134107113 | FALLON (01) | MA |
1134107113 | MBHP (01) | MA |
1134107113 | NHP (01) | MA |
12529 | HNE (01) | MA |
71756 | TUFTS (01) | MA |
997303 | NETWORK HEALTH (01) | MA |
Y10086 | MEDICARE (01) | MA |