1184287757 NPI number — BERKSHIRE ORTHOPAEDIC ASSOCIATES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184287757 NPI number — BERKSHIRE ORTHOPAEDIC ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BERKSHIRE ORTHOPAEDIC ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184287757
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24 PARK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01201-4037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-629-1882
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 HOSPITAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH ADAMS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01247-2504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-664-5699
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2019

Additional Information

Authorized Official

Authorized Official Last Name:
ROBERT
Authorized Official First Name:
YVONNE
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS MANAGER, CLERK
Authorized Official Telephone Number:
413-629-1882

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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