Basic Information
| Provider Information | |||||||||
| NPI: | 1568462448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MASTRANGELO | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 260 NEW LUDLOW RD | ||||||||
| Address2: | WESTERN MASS PHYSICIAN ASSOCIATES, INC. | ||||||||
| City: | CHICOPEE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010204324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135333470 | ||||||||
| FaxNumber: | 4135336859 | ||||||||
| Practice Location | |||||||||
| Address1: | 262 NEW LUDLOW RD | ||||||||
| Address2: | CHICOPEE MEDICAL CENTER | ||||||||
| City: | CHICOPEE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010204324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135523250 | ||||||||
| FaxNumber: | 4135523255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2005 | ||||||||
| LastUpdateDate: | 10/31/2012 | ||||||||
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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 | 363LF0000X | 205310 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0344079 | 05 | MA | MEDICAID | 205310 | 01 | MA | CONNECTICARE OF MA | OTHER | NP2188 | 01 | MA | BLUE CROSS/BLUE SHIELD | OTHER | 043202198007 | 01 | TRICARE | OTHER | NP2188 | 01 | HMO BLUE | OTHER | 043202198 | 01 | CBA | OTHER | 0344079 | 01 | MA | MEDICAID - PCC | OTHER | 043202198 | 01 | BEECH STREET | OTHER |