Basic Information
Provider Information
NPI: 1508954140
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WASSIF
FirstName: HEBA
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 280 CHESTNUT STREET
Address2: 2ND FLOOR
City: SPRINGFIELD
State: MA
PostalCode: 011191001
CountryCode: US
TelephoneNumber: 4137945700
FaxNumber:  
Practice Location
Address1: 164 HIGH ST
Address2:  
City: GREENFIELD
State: MA
PostalCode: 013012613
CountryCode: US
TelephoneNumber: 4137942273
FaxNumber: 4137732841
Other Information
ProviderEnumerationDate: 10/10/2006
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X253394MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X253394MAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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