Provider Demographics
NPI:1447280599
Name:ORTHOPEDIC ASSOCIATES OF NORTHERN BERKSHIRE
Entity type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES OF NORTHERN BERKSHIRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARMENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-664-6111
Mailing Address - Street 1:77 HOSPITAL AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2550
Mailing Address - Country:US
Mailing Address - Phone:413-664-6111
Mailing Address - Fax:413-663-3923
Practice Address - Street 1:77 HOSPITAL AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2550
Practice Address - Country:US
Practice Address - Phone:413-664-6111
Practice Address - Fax:413-663-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9713123Medicaid
MAM12522Medicare ID - Type Unspecified