Basic Information
Provider Information
NPI: 1619382132
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCFEELY
FirstName: ERIC
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 280 W MACARTHUR BLVD
Address2:  
City: OAKLAND
State: CA
PostalCode: 946115642
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 280 CHESTNUT STREET
Address2: 2ND FLOOR
City: SPRINGFIELD
State: MA
PostalCode: 011991001
CountryCode: US
TelephoneNumber: 4137945700
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/23/2014
LastUpdateDate: 11/05/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X281447MAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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