Disandro, Debra A.

Disandro, Debra A. is an individual health care provider with primary practice located at 3550 Main St Ste 302 , Springfield MA 01107-1088. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics, which is considered as her primary health care specialty. Disandro, Debra A. can be contacted via phone (413) 781-8290.

Contact Information

Primary practice address
3550 Main St Ste 302 Springfield MA 01107-1088
Phone: (413) 781-8290
Fax: (413) 737-8540
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 52978 Massachusetts

Profile Details

NPI number 1043219397
LBN Legal business name Disandro, Debra A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Mar 7th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043219397 NPPES
Massachusetts Other 037323836 TRICARE
Massachusetts Other 11833 TRICARE
Massachusetts Other 484978 TRICARE
Massachusetts Other DIJ06185 TRICARE
Massachusetts Other 717957 TRICARE
Massachusetts Other 130705 TRICARE
Massachusetts Other 160039235 TRICARE
Massachusetts Other 782507 TRICARE
Massachusetts Other 0010789 TRICARE
Massachusetts Other 07-04622 TRICARE
Massachusetts MEDICAID 3017699 TRICARE
Massachusetts Other 000006311 TRICARE

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