Basic Information
| Provider Information | |||||||||
| NPI: | 1699739391 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MACHNIK | ||||||||
| FirstName: | NANCIANN | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8019 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011028000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664314077 | ||||||||
| FaxNumber: | 4137747448 | ||||||||
| Practice Location | |||||||||
| Address1: | 329 CONWAY ST | ||||||||
| Address2: | GREENFIELD HEALTH CENTER | ||||||||
| City: | GREENFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 013011526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137746301 | ||||||||
| FaxNumber: | 4137726390 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 06/12/2008 | ||||||||
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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 | 225100000X | 3854 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0386499 | 05 | MA | MEDICAID | 626166 | 01 | MA | HARVARD PILGRIM HEALTHCAR | OTHER | 712451 | 01 | MA | CONNECTICARE | OTHER | Y65787 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 123375 | 01 | MA | FALLON COMMUNITY HEALTH PLAN | OTHER | 24189 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 7663749 | 01 | MA | AETNA/ US HEALTH CARE | OTHER | 00463345 | 01 | MA | RAILROAD MEDICARE PTAN | OTHER | 486929 | 01 | MA | TUFTS HEALTH PLAN | OTHER |