Basic Information
| Provider Information | |||||||||
| NPI: | 1386685402 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHALEN | ||||||||
| FirstName: | EILEEN | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 W SILVER ST | ||||||||
| Address2: | |||||||||
| City: | WESTFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010853678 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 57 UNION ST | ||||||||
| Address2: | STE 101 | ||||||||
| City: | WESTFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010852658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4136427200 | ||||||||
| FaxNumber: | 4135621821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 11/11/2016 | ||||||||
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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 | 207P00000X | 156133 | MA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000033015 | 01 | MA | BMC HEALTH NET | OTHER | 25320 | 01 | MA | HEALTHCARE NEW ENGLAND | OTHER | 930094815 | 01 | MA | RAILROAD MEDICARE | OTHER | 3178340 | 05 | MA | MEDICAID | WHJ18833 | 01 | MA | BLUE SHIELD | OTHER |