OrganizationActive
Genesis Eldercare Physician Services LLC
NPI 1104819259 · Geriatric Medicine (Internal Medicine) Physician · Agawam, MA
Provider details
- NPI number
- 1104819259
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Eric Shapiro, Vp, Controller(410) 832-7790
- License
- 75866 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
464 Main St
Heritage Hall East
Agawam, MA 01001
Phone: (413) 786-8000
Fax: (413) 789-1099
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 62946
Baltimore, MD 21264-2946
Registry dates
- Enumerated
- 2005-08-24
- Last updated
- 2019-08-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.