Basic Information
| Provider Information | |||||||||
| NPI: | 1932179660 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHIULLI | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 LOCUST ST | ||||||||
| Address2: | AMBULATORY CARE PHYSICIANS AT CDH, PC | ||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010602052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135822363 | ||||||||
| FaxNumber: | 4135822914 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 LOCUST ST | ||||||||
| Address2: | AMBULATORY CARE PHYSICIANS AT CDH, PC | ||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010602052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135822363 | ||||||||
| FaxNumber: | 4135822914 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 11/21/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 77986 | MA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 77986 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 101610 | 01 | MA | CIGNA | OTHER | 2359900 | 01 | MA | AETNA | OTHER | 930094279 | 01 | MA | MEDICARE RAILROAD | OTHER | 438620 | 01 | MA | HARVARD PILGRIM HEALTH PL | OTHER | 11282 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 77986 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 000000020638 | 01 | MA | BMC HEALTHNET | OTHER | 632919 | 01 | MA | CONNECTICARE | OTHER | J14071 | 01 | MA | BLUE CROSS AND BLUE SHIEL | OTHER | 3206726 | 05 | MA | MEDICAID |