Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003289927 |
---|---|
Provider Name | Ismael Joel Cintron |
First Address | Springfield, MA 01103-2114 |
Second Address | Springfield, MA 01103-2114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2015 |
Last Update Date | 25/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042622756 | CCA (01) | MA |
1134107113 | BEACON (01) | MA |
1134107113 | FALLON (01) | MA |
1134107113 | MBHP (01) | MA |
1134107113 | NHP (01) | MA |
12529 | HNE (01) | MA |
1307576 | (05) | MA |
71756 | TUFTS (01) | MA |
997303 | NETWORK HEALTH (01) | MA |