Provider Demographics
NPI:1194752337
Name:TIRABASSI, MICHAEL V (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:V
Last Name:TIRABASSI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:413-794-1629
Practice Address - Street 1:100 WASON AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1381
Practice Address - Country:US
Practice Address - Phone:413-794-2442
Practice Address - Fax:413-794-2910
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2019-01-16
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Provider Licenses
StateLicense IDTaxonomies
MA2127332086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery