Provider Demographics
NPI:1528094372
Name:VANSTEE, VANESSA (MD)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:VANSTEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 LOCUST ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2003
Mailing Address - Country:US
Mailing Address - Phone:413-586-0769
Mailing Address - Fax:413-584-0392
Practice Address - Street 1:269 LOCUST ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01062-2003
Practice Address - Country:US
Practice Address - Phone:413-586-0769
Practice Address - Fax:413-584-0392
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218642207K00000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3394242OtherAETNA
MA043194547OtherCIGNA
MA2024781Medicaid
MAJ27042OtherBCBS OF MA
MAAA36002OtherHARVARD PILGRIM HEALTH PL
MA468634OtherTUFTS HEALTH PLAN
MA000000030213OtherBMC HEALTHNET
MA33434OtherHEALTH NEW ENGLAND
MA218642OtherCONNECTICARE
MAAA36002OtherHARVARD PILGRIM HEALTH PL
MAS400181777Medicare UPIN
MAA36247Medicare ID - Type Unspecified