MACKENZIE MALCOLM GRAY (NPI# 1407479272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407479272 |
| Entity Type | Individual |
| Full Name | MACKENZIE MALCOLM GRAY |
| Credential | PA-C |
| Practice Address |
35 Pynchon Rd Holyoke MA 01040-1514 |
| Mailing Address |
271 Carew St Springfield MA 01104-2377 |
| Practice Telephone | 4132308077 |
| Mailing Telephone | 4137489000 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-09-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA7598 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
35 PYNCHON RD |
| City | HOLYOKE |
| State | MA |
| Zip Code | 01040-1514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945325 | Holyoke Care Center, LLC | Skilled Nursing Facility | Holyoke Care Center, LLC, 35 Holy Family Road, Holyoke, MA 01040 | 2020-09-04 |
| 1225646904 | Jasmine Glover | Counselor | 476 Appleton St. Suite 5, Holyoke, MA 01040 | 2020-07-17 |
| 1932662319 | Damaris Santingo Martinez | Registered Nurse | 46 Magnolia Ave, Holyoke, MA 01040 | 2019-04-11 |
| 1104302371 | Cheryl Ann Lauben | Counselor | 476 Appleton Street, Suite 2, Holyoke, MA 01040 | 2018-07-11 |
| 1740704741 | Miranda Lynn Fogg | Behavior Technician | 244 Westfield Rd, Holyoke, MA 01040 | 2017-08-01 |
| 1770020018 | Total Wellness Centers, LLC | Clinical Medical Laboratory | 59 Bobala Rd, Holyoke, MA 01040 | 2017-01-25 |
| 1184097768 | Chi Wan Wong | Physical Therapy Assistant | 110 Cherry Street, Holyoke, MA 01040 | 2015-11-04 |
| 1841666724 | Danielle Moroney | Counselor | River Valley Counseling Center Mental Health Service, 303 Beech St, Holyoke, MA 01040 | 2015-08-14 |
| 1285019638 | Ashley Papineau | Social Worker | 9 Faille Ave, Apt 3, Holyoke, MA 01040 | 2015-07-28 |
| 1205216967 | Vanessa Vazquez | Counselor | 1233 Main St., Holyoke, MA 01040 | 2015-06-08 |
| Find all providers in zip 01040 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780069310 | Adrienne Thibodeau | Physician Assistant | 2 Hospital Dr, Suite 203, Holyoke, MA 01040-6632 | 2015-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627106 | Taia Maria Tieland | Physician Assistant | 9 Hunting St Apt 1, Cambridge, MA 02141-1010 | 2020-07-24 |
| 1003434275 | Antonious Jonah Abraham | Physician Assistant | 99 Corn Rd, Bolton, MA 01740-1055 | 2020-07-13 |
| 1780235333 | Emily Fregeau | Physician Assistant | 1 Canal St Unit 518, Boston, MA 02114-2053 | 2019-09-25 |
| 1992369524 | Jaclyn Hynes | Physician Assistant | 234 Otis St, Hingham, MA 02043-4504 | 2019-04-29 |
| 1376002931 | Jack City, LLC | Physician Assistant | 290 Pleasant St Apt 212, Watertown, MA 02472-2429 | 2019-03-13 |
| 1578021911 | Ashley Piemonte | Physician Assistant | 15 1/2 Russell St Apt 1, Charlestown, MA 02129-2492 | 2019-03-05 |
| 1407323686 | Nicole Burke Tingley | Physician Assistant | 123 Summer St Ste 277, Worcester, MA 01608-1216 | 2018-10-25 |
| 1386111706 | Nicole Laura Solman | Physician Assistant | 16 Deerhaven Rd, Lincoln, MA 01773-1806 | 2018-10-24 |
| 1881160943 | Philip Apraku Bondzie | Physician Assistant | 266 Sportsmans Trl, Whitman, MA 02382-1726 | 2018-10-16 |
| 1912488966 | Caily Chandler Irwin | Physician Assistant | 235 Cypress St Unit 201, Brookline, MA 02445-6776 | 2018-08-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.