Basic Information
| Provider Information | |||||||||
| NPI: | 1144485145 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROCA MATTEI | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | MERCEDES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 260 NEW LUDLOW RD. | ||||||||
| Address2: | |||||||||
| City: | CHICOPEE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135368924 | ||||||||
| FaxNumber: | 4135329141 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 HOSPITAL DR., SUITE 101 WESTERN MASS PHYSICIAN ASSOCI | ||||||||
| Address2: | D/B/A: HOLYOKE ASSOCIATIES IN INTERNAL MEDICINE | ||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135368924 | ||||||||
| FaxNumber: | 4135329141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2008 | ||||||||
| LastUpdateDate: | 02/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 252723 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 110094126A | 05 | MA | MEDICAID |